ADJUSTMENT TO AGING AMONG LBGT+ OLDER ADULTS

Abstract Intervention programs that highlight predictors of adjustment to aging (AtA)(1) for minority older lesbian, gay and bisexual (LGB) populations are scarce(2).The aim of this preliminary study is to build a structural model to explore whether socio-demographic, health and lifestyle-related variables, are correlates of AtA in a group of LGB older adults(3).The sample comprised 287 LGB older adults aged 75 years old and older.Convenience sampling was used to gather questionnaire data.Measures encompassed the Adjustment to Aging Scale, the Satisfaction with Life Scale, demographics and lifestyle and health-related characteristics.Structural equation modeling was used to explore a structural model of the self-reported AtA, comprising all the above variables.The structural model indicated the following significant correlates: perceived health(β=0.456; p< 0.001), leisure(β=0.378; p< 0.001), income(β=0.302; p< 0.001), education(β=0.299; p=0.009), spirituality(β=0.189; p< 0.001), sex(β=0.156; p< 0.001), physical activity(β=0.142; p< 0 .001), satisfaction with life(β=0.126; p< 0.001), and marital status(β=0.114; p=0.008).The variables explain respectively 76.4% of the variability of AtA. These outcomes suggest that policy making and community interventions with LGB older adults may benefit of including variables, such as, perceived health, leisure and income, as these were pointed out as significant for this group of older adults for promoting adjustment to aging in late adulthood. 1.von Humboldt S et al. How do older adults experience intergenerational relationships? Different cultures, ambivalent feelings. Educ.Gerontol.2018;44(8):501-513. 2.von Humboldt S et al. Analyzing adjustment to aging and subjective age from Angolan and Portuguese community-dwelling older adults' perspectives. Int.J.Gerontol.2013;7(4):209-215. 3.von Humboldt S et al. What influences the subjective wellbeing of older adults?: A systematic review of the literature. Rev.Argent.Clín.Psicol.2014;23(3):219-230.

Literature suggests racial implicit bias can significantly affect quality of care.Data demonstrates that older adult Blacks are twice as likely to have dementia as their White counterpart.Inappropriate cognitive screening by providers or diagnosing dementia just based on clinical impression could easily result in an over or under-estimation of the dementia.We reviewed the rate and method of cognitive screening in randomly selected patient records (n=75) at a primary care university clinic.Our results indicated that the cognitive screening rate for Black patients was lower compared to their White counterpart (43.4% Blacks vs 68.5% Whites, p < 0.05).We designed a quality improvement project to identify any contributory causes and challenges involved in screening for dementia with the goal to reduce racial disparity in dementia diagnosis.We identified knowledge deficits in providers in their approach towards patients with dementia and a lack of experience in their use of appropriate instruments for cognitive screening.A multipronged educational program, with videos, case conferences, presentations and one-to-one training by dementia experts and a neuropsychologist was employed to reduce the bias and train the providers in appropriate screening methods.Posteducational intervention, screening rates greatly improved in n=75 randomly selected patients from both races.In Whites, the screening rate increased by 20.9% to 89.4% and in Blacks by 38.9% to 82.3% (p < 0.05).Overall, the quality improvement driven educational intervention improved the self-efficacy of providers and improved the standardized dementia screening rates in Black patients to levels comparable to those of White patients.

RACIAL DIFFERENCES IN THE ASSOCIATION BETWEEN LONELINESS AND COGNITIVE STATUS AMONG BLACK AND WHITE MEN
Marino Bruce 1 , Bettina Beech 2 , Gillian Marshall 3 , and Roland J. Thorpe, Jr. 4 , 1. University of Houston Tilman J. Fertitta Family College of Medicine,Houston,Texas,United States,2. University of Houston,Houston,Texas,United States,3. University of Washington,Seattle,Washington,United States,4. Johns Hopkins University,Baltimore,Maryland,United States Background: Loneliness is a stressor that has been found to increase the likelihood of poor health and dementia.Few studies have focused on this association among men and even fewer studies have examined racial disparities in loneliness and cognitive functioning among this group.The purpose of this study was to examine racial differences in the association between loneliness and cognitive functioning among national sample of men aged 50 years and older.
Methods: Data were drawn from Black and White men in the 2016 Health and Retirement Study who completed the Leave Behind Questionnaire (n=2226).Cognitive function was the primary outcome and was measured by a dichotomous variable derived from a modified version of the Telephone Interview for Cognitive Status.Loneliness was the primary independent variable and was derived from the 3-item UCLA Loneliness Scale.
Results: Black men made up 18.5% of the study sample; however, the proportion of this group with scores indicating cognitive impairment or dementia (35.9%) doubled the corresponding percent of white men (17.6%).Findings from race-stratified modified Poisson regression models indicated that loneliness was associated with a higher prevalence of cognitive impairment or dementia for White men (PR=1.24,CI:1.05-1.47),but Black men (PR=0.92,CI:0.73-1.16).
Conclusions: Results from this study raise important questions about the salience of pooled analyses and suggest a need for tailored approaches to mitigate cognitive decline.Additional studies focusing on Black men are needed to develop effective interventions preserving cognitive functioning among this population.Sofia von Humboldt, Francis Carneiro, and Isabel Leal, ISPA -Instituto Universitário, Lisbon, Lisboa, Portugal Intervention programs that highlight predictors of adjustment to aging (AtA)(1) for minority older lesbian, gay and bisexual (LGB) populations are scarce(2).The aim of this preliminary study is to build a structural model to explore whether socio-demographic, health and lifestylerelated variables, are correlates of AtA in a group of LGB older adults(3).The sample comprised 287 LGB older adults aged 75 years old and older.Convenience sampling was used to gather questionnaire data.Measures encompassed the Adjustment to Aging Scale, the Satisfaction with Life Scale, demographics and lifestyle and health-related characteristics.Structural equation modeling was used to explore a structural model of the self-reported AtA, comprising all the above variables.The structural model indicated the following significant correlates: perceived health(β=0.456;p< 0.001), leisure(β=0.378;p< 0.001), income(β=0.302;p< 0.001), education(β=0.299;p=0.009), spirituality(β=0.189;p< 0.001), sex(β=0.156;p< 0.001), physical activity(β=0.142;p< 0 .001),satisfaction with life(β=0.126;p< 0.001), and marital status(β=0.114;p=0.008).The variables explain respectively 76.4% of the variability of AtA.These outcomes suggest that policy making and community interventions with LGB older adults may benefit of including variables, such as, perceived health, leisure and income, as these were pointed out as significant for this group of older adults for promoting adjustment to aging in late adulthood.

ADJUSTMENT TO AGING AMONG LBGT+ OLDER ADULTS
Rio Tate, and Brent Small, University of South Florida, Tampa, Florida, United States African Americans are more likely to have Alzheimer's Disease (AD) yet less likely to be included in AD research.Additionally, memory complaints may signal the clinical genesis of AD.Interventions such as physical activity that can help individuals maintain their cognitive functioning as they age have merit in research.The objective of this study