Effects of Social Networks and Policy Context on Health among Older Sexual and Gender Minorities in the US South

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PROJECT SUMMARY No changes being proposed. INTRODUCTION This application is for an Administrative Supplement for Research on Sexual and Gender Minority (SGM) Populations (NOT-OD-22-032) to the parent award, ““Effects of Social Networks and Policy Context on Health among Older Sexual and Gender Minorities in the US South,” (R01AG063771). This application proposes to extend the parent award’s existing data collection among a panel of older sexual and gender minority (SGM) adults to include new objective measures of cognitive functioning. The parent award already includes self-reported cognitive functioning and analyses of cognition-related outcomes are within the scope of the parent award. As such, this proposal seeks to extend the range of SGM-related data and research questions on health and aging through the expansion of measures that are not available in this population. As we note in the strategy, there are currently no studies that directly measure cognitive functioning in self-identified SGM older adults regardless of relationship status and only one cross-sectional study has tested cognitive abilities across gender and sexual orientation in a sample inclusive of older adults (age 20-65).1 Very little work on self-reported cognitive aging in SGM populations is able to disaggregate the experiences and outcomes of SGM people by identity or other exposures (e.g., negative life experiences) due to small sample sizes. Several recent reports, including the 2023 Federal Evidence Agenda on LGBTQI+ Equity, highlight the lack of data on SGM populations that can be disaggregated to consider within-group variation in outcomes and mechanisms.2 The collection of new objective measures of cognitive functioning alongside the already-robust survey and biomarker infrastructure of the Vanderbilt University Social Networks, Aging, and Policy Study (VUSNAPS) will address both concerns by directly measuring cognitive functioning in a SGM sample that includes partnered and unpartnered older adults that is large enough to detect differences among cisgender and transgender/gender diverse SGM people, and among gay/lesbian and bisexual people. Additionally, these collection of cognitive functioning measures would contribute to new research on key questions that members of the VUSNAPS research network motivated to pursue, including: 1. Do SGM and nonSGM older adults differ in cognitive functioning and cognition trajectories in later life? 2. Are there within-group differences in cognitive functioning and cognition trajectories among the SGM population? 3. Are these differences attributable to minority stress exposures via inflammation, immune dysregulation, mental distress, and sleep disruption pathways? 4. Are the needs of SGM older adults experiencing cognitive decline different for those with and without partners/spouses and kin ties? Although no funds are specifically requested for training on this supplement, training and mentorship of DEIA trainees continues to be a primary goal of the VUSNAPS. The project has made significant investments in the training of diverse future health professionals, including 4 postdoctoral trainees, 3 graduate students, and 15 undergraduate students. We have completed a Diversity Supplement (R01AG063771-02S1) and have an active a Diversity Mentoring Supplement (R01AG063771-04S2) that aims to expand training opportunities in SGM health disparities by providing a two-day workshop to 25 junior, postdoc, and graduate researchers SGM aging and use of biomarkers in health disparities research. Our work has also generated multiple new training applications, including an R36 (Tran), a K01 (Barbee), and two LRP applications (Lampe and Barbee). Together, the activities we outline in this application will substantially improve the quality of date available on cognitive aging among SGM populations, extend the impact of NIH investments in the parent award, improve diversity and inclusion of SGM people in aging research, provide new opportunities for training SGM health disparities researchers, and contribute to new field-driving research on SGM cognitive aging.