The Epidemiology of Alzheimer's Disease and Related Dementias in Sexual and Gender Minority Older Adults: Identifying Risk and Protective Factors

摘要 到2030年，将有近600万60岁及以上的性和性别少数（SGM）老年人， 在美国，同性恋、双性恋和变性者。大约有350，000名SGM老年人， 美国目前有阿尔茨海默病和相关痴呆症（ADRD），预测接近1 到2030年，亿。然而，对于SGM老年人ADRD的患病率或风险几乎一无所知 没有艾滋病毒/艾滋病。该提案将重点关注SGM老年人ADRD的流行病学和风险。第一 该提案的目的是在以下人群中描述ADRD的流行病学和风险： SGM老年人中ADRD的患病率和发生率，并将SGM老年人与 异性恋同伴第二个目标将侧重于确定SGM老年人ADRD的风险和保护因素 成年人，并估计抑郁症的人群归因风险和社会经济地位（例如，收入 （一）关于ADRD。第三个目标是在社区抽样中收集原始数据， SGM老年人为了调查风险和保护因素与认知之间的关系， 包括记忆和执行功能。该提案包含了几项创新，使我能够 评估SGM老年人认知障碍和ADRD的流行病学和风险：1）这将是 首次研究流行病学和认知障碍和ADRD的相关风险和保护因素， SGM老年人; 2）它利用了全国最大的纵向数据集，基因研究计划 环境与健康（RPGEH），提供关于SGM老年人身体和心理健康的数据;以及 3)它涉及到一个新的调查因素可能与记忆和执行功能 老年人SGM受损。为了顺利完成本研究，我提出了三个培训目标： ADRD风险和保护因素的高级统计建模; 2）SGM老化和健康的流行病学 认知老化的测量与分析。这一职业发展奖最终将 导致提交R 01，以开发未来的认知老化多地点流行病学研究， SGM老年人中的ADRD。鉴于目前对这一人群的ADRD风险一无所知，这项工作 有必要促进早期发现;发展文化上相关的筛查和有针对性的预防措施， 干预措施，以降低SGM老年人的ADRD风险;并改善其护理和生活质量。 弱势和未被充分研究的人群。

Abstract By 2030, there will be nearly six million sexual and gender minority (SGM) older adults aged 60 and older in the U.S. who identify as lesbian, gay, bisexual and transgender. Approximately 350,000 SGM older adults in the U.S. currently have Alzheimer’s disease and related dementias (ADRD), with projections nearing one million by 2030. Yet, almost nothing is known about the prevalence or risk of ADRD in SGM older adults without HIV/AIDS. This proposal will focus on the epidemiology and risk of ADRD in SGM older adults. The first aim of this proposal is to characterize the epidemiology and risk of ADRD in a population-based sample of SGM older adults and compare the prevalence and incidence of ADRD in SGM older adults to their heterosexual peers. The second aim will focus on identifying risk and protective factors for ADRD in SGM older adults, and to estimate the population attributable risk of depression and socioeconomic status (e.g., income and education) on ADRD. The third aim will involve primary data collection in a community-based sample of SGM older adults in order to investigate the relationship between risk and protective factors and cognition, including memory and executive function. This proposal incorporates several innovations that will allow me to evaluate the epidemiology and risk of cognitive impairment and ADRD in SGM older adults: 1) this will be the first study of the epidemiology and associated risk and protective factors for cognitive impairment and ADRD in SGM older adults; 2) it leverages the largest longitudinal dataset in the nation, Research Program for Genes Environment and Health (RPGEH), with data on the physical and psychosocial health of SGM older adults; and 3) it involves a novel investigation of factors that may be associated with memory and executive function impairment in SGM older adults. To successfully complete this research, I propose three training aims: 1) advanced statistical modeling of ADRD risk and protective factors; 2) epidemiology of SGM aging and health disparities; and 3) measurement and analysis of cognitive aging. This career development award ultimately will result in the submission of a R01 to develop a future multi-site epidemiological study of cognitive aging and ADRD in SGM older adults. Given that nothing is currently known about ADRD risk in this population, this work is necessary to promote early detection; to develop culturally relevant screenings and targeted preventative interventions to decrease ADRD risk in SGM older adults; and to improve the care and quality of life of this vulnerable and understudied population.