Determinants of loneliness and depressive symptomatology among LGBTQ older adults living with cognitive impairment
Bibliographic record
Abstract
Abstract Background Loneliness and depression among older adults are linked to a higher likelihood of chronic diseases, deterioration of physical function, and compromised quality of life. LGBTQ older adults are known to experience social isolation and mental distress at higher rates than their heterosexual counterparts, and those with cognitive impairment may be particularly susceptible to loneliness and depression. However, there is limited knowledge regarding the risk and protective factors for loneliness and depression among LGBTQ older adults living with cognitive impairment. This study fills this critical research gap and provides insights to improve the well‐being of this historically marginalized and underserved population. Method A sub‐sample (N = 160) of the Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), the first longitudinal study of LGBTQ adults aged 50 and older in the U.S., was used. Those who were identified as experiencing cognitive impairment based on their Montreal Cognitive Assessment (MOCA) scores were included in this study. The MOCA scores ranged from 14 to 25 with a mean score of 22.1 (SD = 2.7). Mixed models were tested to identify factors predicting the overall levels and slopes of loneliness and depressive symptomatology over 6 years (2014 – 2020). Result The mean age was 68 (range: 50 – 97) with 69% men, 44% people of color, 55% with income below 200% federal poverty guideline, and 22% with high school or less education. Half reported feeling lonely, and about 30% had clinical‐level depressive symptoms. After controlling for background characteristics, loneliness and depressive symptomatology were positively associated with everyday discrimination, sub‐optimal sleep, and limited social resources. Loneliness was also positively associated with being single and limited outdoor activity, and depressive symptomatology with identity stigma and malnutrition. Loneliness increased over time if being single. Conclusion Findings identify modifiable factors that may provide protection against loneliness and depressive symptomatology. Individuals living with cognitive impairment and no care partner had loneliness increase over time, which is of particular concern. This study provides evidence‐based information for the development of tailored interventions, addressing LGBTQ‐specific needs as well as enhancing independence in daily living and overall quality of life.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".