PROJECTS

Older Adults Living with Alzheimer’s Disease and Caregivers: Testing Evidence-Based Intervention for Underserved Populations

The Institute of Medicine identifies lesbian, gay, bisexual, and transgender (LGBT) older adults as one of the most underserved populations, with significant health disparities. This at-risk group faces serious barriers to healthcare access, bias in health settings, and a lack of culturally competent care. The number of LGBT older adults living with Alzheimer’s disease and related disorders (AD) and their caregivers (CGs) are growing rapidly, and will exceed 4 million by 2060. The lack of efficacious research-based interventions implemented to reduce disability and depression, and improve quality of life for LGBT older adults living with AD and their CGs, is a significant public health problem. Research has documented the protective role of CGs in the health of older adults living with AD as well as CGs’ hardships and challenges in caregiving and the impact of caregiving on health deterioration. Caregiving of LGBT older adults with AD is particularly of concern due to this population’s lower rate of cross-generational ties and their social stigma and disconnectedness, which may be barriers to sustaining caregiving relationships. This project builds on the success of two major NIH projects, Aging with Pride: National Health, Aging, Sexuality and Gender Study (2R01 AG026526; K. Fredriksen-Goldsen, PI) and Reducing Disabilities in Alzheimer’s Disease (RDAD); R01 AG10845; L. Teri, PI) and will test the efficacy of an enhanced RDAD intervention for stigmatized populations addressing identity management, historical trauma and diverse peer support networks. The project will address the following aims: Aim 1. Test the translation and enhancement of RDAD, a community evidence-based intervention designed for improving physical activity and functioning of CGs, and demographically diverse LGBT older adult care recipients (CRs) living with AD; and reducing stress of CGs and institutionalization of CRs; Aim 2. Examine the influence of enhanced and standard RDAD on secondary outcomes of CGs and CRs: health-related quality of life (HRQOL) and depressive symptomatology for CGs and CRs, and behavioral disturbance for CRs; and Aim 3. Evaluate the long-term effect of the enhanced and standard RDAD. The team of nationally recognized experts have more than 20 years of conducting Alzheimer’s and LGBT aging research, with the expertise and established relationships necessary to conduct and test the first evidence-based intervention for demographically diverse CGs and LGBT older adults living with AD. The findings from this study will be fully disseminated through caregiving and aging agencies, LGBT organizations, and research networks across multiple sites and settings.