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Cannabis is the most commonly-used drug in the US, with older adults being the fastest-growing group of users. National surveys among 50+ adults found poorer executive function among current or past cannabis users, but better performance with daily users. However, there is little evidence linking levels of cannabis use and subjective cognitive decline (SCD) among middle-age and older adults. This study sought to examine the association between levels of cannabis use in the past 30 days and SCD during the past 12 months using Behavioral Risk Factor Surveillance System (BRFSS) data (2016-2019) from 45+ individuals while controlling for demographics, chronic conditions, exercise, general and mental health. Logit models with SCD as outcome were estimated using complex survey weights. Multiple group analyses examined differences across age groups: 45-64 vs. 65+. Levels of cannabis use in the past 30 days were categorized as: no use, 1-4 days, 5-20 days; and 21-30 days. Adjusted results indicated that those who reported no cannabis use were from 35% to 47% less likely to report SCD compared to cannabis users at all levels: 1-4 days (OR=0.65, 95%CI=0.46, 0.92); 5-20 days (OR=0.53, 95%CI=0.36,0.78); 21-30 days (OR=.61, 95%CI=0.45,0.83). In multi-group analyses, levels of cannabis use effects on SCD remained statistically significant in the 45-64 age group, but not in the 65+ group. Further research targeting SCD is needed to design interventions particularly for middle-age cannabis users whose health has been compromised by disease or age-related vulnerabilities and are at greater risk for adverse cognitive outcomes from cannabis use.

This study highlights primary caregivers’ experiences with health department policies designed to support people with cognitive impairment/Alzheimer’s Disease and Related Dementias (ADRD). Caregivers were defined as individuals aged 45-85 that provide at least 10 hours of unpaid care. Five, 90-minute focus groups were conducted virtually with 24 caregivers of individuals with cognitive impairment/ADRD. Transcripts were analyzed thematically. Caregivers were primarily Black females (75%) with at least a high school education (42%). Care recipients were likely to be community-dwelling parents (71%), with moderate or advanced (79%) dementia. Caregivers described challenges with accessing resources intended for care recipients, especially as cognitive impairment worsened. Caregivers reported providing care 24/7 as traumatizing. Home-based personal aides and companionship services did not reduce this burden. COVID-19 impacted caregivers and care recipient’s access to resources increasing burden. Policies need to be flexible for ever-changing needs of individuals with ADRD and support the overall well-being of the caregivers.

Despite the clear and compelling association between social connections and well-being, the underlying mechanisms that help stave off adverse health impacts are not well understood, particularly among older adults in disadvantaged groups. Social relationships in older age may be instrumental for exchanging and gaining knowledge that further influence health and help increase awareness about misconceptions and lifestyle behaviors known to delay or reduce cognitive decline. This study used cross-sectional survey data from 147(aged 58-90 years; 75% female) low-income African American homebound community dwellers to investigate heterogeneity in dementia literacy profiles and its association with social connectedness. Eleven items (false=0, true=1, don’t know=2) from a validated instrument were used to measure dementia literacy (DL). The Lubben’s social network scale was used for a social connectedness construct. We employed a 2-stage latent class modeling approach to examine heterogeneity in DL and estimate the regressions among the derived classes and the predictors (social connectedness, education level and age). A 3-class model produced a reasonable fit and classification (entropy=0.852) of “dementia literacy patterns” labeled as (high-literacy:37%), moderate-literacy:45.2%), low-literacy:17.8%)). Social connectedness was highly predictive of class membership. A high level of social relationships increased the probability of being in the “high-dementia-literacy” class compared to the “low-dementia-literacy” class (OR=2.189, p=0.016). For a unit increase in social connectedness, the odds of being in the “high-dementia-literacy” class compared to the “low-dementia-literacy” class increased by a factor of 2.2. Tailored and focused interventions to reduce social disconnectedness may also help increase dementia awareness and reduce barriers to early diagnosis.

Physical/functional limitations are known to lead to loneliness, but there is little research on protective factors that may mediate their adverse association, particularly in vulnerable populations. This study used cross-sectional survey data from 147 (aged 58-90 years; 75% females) predominantly low-income African American homebound community dwellers to investigate the role of resilience and social connectedness in mediating the effect of physical/functional limitations on loneliness. Items from validated instruments were used to measure four latent variables (physical/functional limitations, resilience, loneliness and social connectedness). Structural parallel mediator models estimated each path in the mediation analysis controlling for gender, education, and age. Confidence intervals for mediation effects were generated via bias-corrected bootstrapping with 10,000 replications. The total effect of physical/functional limitations on perceived loneliness was significant. Social connectedness and resilience fully and significantly mediated the relationship between physical/functional limitations and loneliness. The indirect effect (B =.143; 95% CI = .047, .280) for the physical/functional limitations-resilience-loneliness pathway indicated that the positive effect of physical/functional limitations on loneliness was approximately 0.143 points lower as mediated by higher resilience. The indirect path of physical/functional limitations on loneliness through the mediation of social connectedness (B =.077; 95% CI = .010, .168) yielded a reduction of .077 points. The total amount of variance in feelings of loneliness accounted for by the overall model, which included the proposed mediators and control variables, was 48.6%. Interventions to build resilience and social interactions may attenuate the effects of physical/functional disability and loneliness on health outcomes in individuals at risk.

Dementia prevalence among sexual minority adults age 60+ in the US is approximately 7.4%. This represents over 200,000 sexual minority older adults living with Alzheimer’s disease (AD). Compared to the general aging population, LGBTQ older adults face unique challenges throughout their life-course that may increase exposure to risk factors associated with neurocognitive dysfunction and progression to dementia. Culturally-competent instruments to measure dementia literacy are needed to inform the design of targeted educational interventions for early diagnosis and improved health outcomes. We sought to develop and test a measure of dementia literacy in a community sample of LBGTQ older adults. Following a comprehensive analysis of existing scales, items were adapted resulting in a 35-item survey containing subjective and objective literacy measures. Participants were recruited through community centers in Washington, DC and Maryland. Forty LGBTQ older adults (50-80 years) completed the questionnaire. The analysis of these data was used to modify the original survey. A final 25-item questionnaire was administered to another sample of 50 individuals. 60% correctly identified dementia symptoms from vignettes. Nearly-half believed that dementia symptoms could be reduced by lifestyle changes and drug therapies. Commonly identified risks for dementia included aging, family history, genetics, stroke, and brain injuries. Frequently-endorsed methods for risk reduction included physical activity, intellectual/brain training and social activities. Education level, age, and socioeconomic variables were strongly associated with literacy. Most respondents did not associate cardiovascular/metabolic risk factors with dementia risk. Knowledge of risk factors underlying AD may help underserved populations close current health disparities gaps.