Evaluation of the Savvy Caregiver Program for LGBTQIA Adults Living With Alzheimer's Disease and Related Dementias

Abstract Approximately 350,000 LGBTQIA+ older adults in the U.S. currently have Alzheimer’s disease and related dementias (ADRD), with projections nearing 1 million by 2030. LGBTQIA+ older adults face challenges in receiving adequate and inclusive care and caregiving support due to the inability to rely on traditional family networks, greater disability, and discrimination when seeking aging services. Working with the Los Angeles LGBT Center Aging in Community Initiative, we evaluated the: 1) Adaptation of the Savvy caregiver training program for care providers of LGBTQIA+ persons living with ADRD; and 2) Feasibility and acceptability of the program. Care providers were very satisfied with the program, strategies, information, and activities of the tailored Savvy program. For psychosocial outcomes, there were trends in greater care planning, increases in asking friends/family for support, and decreased loneliness. Additional research is needed on culturally-relevant aging services and behavioral interventions for care providers of LGBTQIA+ persons living with ADRD.


MEMORY-RELATED LIMITATIONS AND CARE NEEDS OF GENDER MINORITY BIPOC ADULTS
Ethan Cicero, 1 Nickolas Lambrou, 2 Whitney Wharton, 3  and Jason Flatt, 4 1.Emory University School of Nursing, Atlanta, Georgia, United States, 2. University of Wisconsin,Madison,Madison,Wisconsin,United States,3. Emory University,Atlanta,Georgia,United States,4.University of Nevada Las Vegas, Las Vegas, Nevada, United States Limited research exists investigating cognitive impairment and Alzheimer's disease and related dementias (ADRD) among gender minority (GM) adults (transgender/ non-binary/, including examining memory-related challenges among GMs who also identify as Black, Indigenous, or People of Color (BIPOC).2015-2019 Behavioral Risk Factor Surveillance System data were used to explore care needs of GM and cisgender (CG) adults with subjective cognitive decline (SCD, N=441), which may be the first clinical manifestations of ADRD.Regression models examined SCD-associated functional limitations and care needs among GM-BIPOC, GM-White, CG-BIPOC, and CG-White adults.GM-BIPOC and GM-White were 2-4x more likely to have SCD-related limitations, require assistance with daily tasks, be unable to do day-to-day or social activities when compared to CG-White.GM-BIPOC were 2-5x more likely to be uninsured and experience cost-related healthcare barriers compared to GM-White and CG-White/BIPOC.Additional research is needed to improve care and well-being for this understudied population.

OPTIMISM AND HEALTH: RESOURCE OR DELUSION William Chopik, Michigan State University, East Lansing, Michigan, United States
There is a general, widely-held belief that optimism is always a good thing.While there is much previous research suggesting that optimists enjoy several health and wellness benefits, there is also a large body of research suggesting that optimism is not always advantageous.Examining how optimism develops and changes across the lifespan may give us insight into how we use optimism and allow us to determine if and when optimism is helpful or maladaptive.In this talk, I will review evidence debating the efficacy of optimism, as well as examine how optimism develops across the lifespan.I also discuss how life events may or may not impact the developmental trajectory of optimism.Lastly, I address currently unanswered questions and emphasize the contextual nature of optimism's advantages.Ultimately, being persistently optimistic about the future is a nearly universal human trait.But the exact contexts in which this positive thinking is helpful--if ever--is an intriguing question that speaks to how we think about ourselves, how we think about others, and how we think about our many possible futures.

MARITAL QUALITY AND HEAVY ALCOHOL USE AMONG OLDER COUPLES
Angela Curl, Jennifer Bulanda, and Amy Restorick Roberts, Miami University, Oxford, Ohio, United States Supportive marital relationships may reduce partners' problematic health behaviors, whereas unhappy relationships may lack efficacious spousal monitoring of health and increase the likelihood of using maladaptive coping strategies, such as heavy alcohol use, to deal with relationship problems.We used pooled data from the 2014 and 2016 waves of the Health and Retirement Study to examine how both partners' perceptions of marital quality were associated with heavy drinking.Our analytic sample included married couples in which both spouses were over age 50, completed the leave-behind psychosocial questionnaire, and provided non-missing data on marital quality and alcohol use (n=2,095 couples).Measures included both positive and negative dimensions of marital quality and controls for sociodemographic, economic, health, household and marital characteristics.Using Proc Glimmix, we estimated a dualintercept Actor-Partner Interdependence Model (APIM), in which separate equations were computed simultaneously for husbands and wives.For husbands, higher negative marital quality was associated with an increase in the odds of their own heavy drinking (OR=1.27),but there was no significant association between wives' marital quality and husbands' heavy drinking behavior.For wives, marital quality was not significantly associated with their own heavy drinking, but husbands' higher ratings of both negative and positive marital quality increased the risk of wives' heavy drinking (OR=1.60 and OR=1.75, respectively).Results suggest that marital quality is associated with heavy drinking in later life: self-ratings of marital quality matter for men, whereas spousal perceptions of marital quality are more important for women.

MARITAL STATUS, MARITAL TRANSITIONS, AND SLEEP QUALITY IN MID TO LATE LIFE Kristin August, Rutgers University, Camden, Camden, New Jersey, United States
Sleep is an important behavior in the prevention and management of chronic conditions in later life.Marital status may account for variability in sleep quality, but little is known about this association in the later part of life or how transitions into and out of marriage are related to changes in sleep quality.This study used the resource model and crisis model as frameworks to understand how marital status and marital transitions were related to sleep quality in mid to late life and whether these findings differed by gender.Interview data from 2,872 participants 50-74 years old (M=59.77years; 63.7% women) from the ORANJ BOWL, a longitudinal panel study in New Jersey, were used.Marital status and sleep quality were examined in two waves approximately 10 years apart.All analyses controlled for health and sociodemographic characteristics.Weighted regressions revealed that individuals in committed romantic relationships and women had worse sleep quality than those in other marital status groups and men (p<.005).Weighted fixed effects regressions revealed that compared to individuals who remained married, individuals who remained divorced or widowed or who became widowed had better sleep quality, whereas those who became divorced had worse sleep quality (ps<.05);individuals who transitioned into marriage had better sleep quality than those who remained divorced or widowed (ps<.03).Findings differed depending on the index of sleep quality examined.Efforts to understand which middle-aged and older adults are most vulnerable to sleep disturbances can inform the design of interventions to promote better sleep quality.
LGBTQIA+ older adults face challenges in receiving adequate and inclusive care and caregiving support due to the inability to rely on traditional family networks, greater disability, and discrimination when seeking aging services.Working with the Los Angeles LGBT Center Aging in Community Initiative, we evaluated the: 1) Adaptation of the Savvy caregiver training program for care providers of LGBTQIA+ persons living with ADRD; and 2) Feasibility and acceptability of the program.Care providers were very satisfied with the program, strategies, information, and activities of the tailored Savvy program.For psychosocial outcomes, there were trends in greater care planning, increases in asking friends/family for support, and decreased loneliness.Additional research is needed on culturally-relevant aging services and behavioral interventions for care providers of LGBTQIA+ persons living with ADRD.William Chopik, PhD, of Michigan State University.The recipient of the 2021 Baltes Award is Laura B. Zahodne, PhD, of the University of Michigan.The Margret M. and Paul B. Baltes Foundation Award in Behavioral and Social Gerontology recognizes outstanding early-career contributions in behavioral and social gerontology.The award is generously funded by the Margret M. and Paul B. Baltes Foundation.