Since 1983, June’s designation as National Alzheimer’s and Brain Health Awareness Month has provided an annual opportunity to raise awareness about dementia. June was also Pride Month, and this year contained the new federally recognized holiday, Juneteenth.
Reflecting upon the different historical and present-day experiences of communities, Age Friendly Seattle recently convened a fascinating group of panelists to shed light on the intersectionality of race, sexual orientation, aging, and brain health. These experts brought diverse perspectives from academic, government, and community-based organizations. Some of their insights are captured in this article, but the full program is well worth a listen (YouTube).
It is important to note that many LGBTQ+ people are thriving in their later years. However, Lionel Wang, facilitator for the Alzheimer’s Association Washington State Chapter’s LGBTQAI+ affirming caregiver support group, underscores that the LGBTQ+ community faces unique challenges when it comes to dementia and caregiving. LGBTQ+ couples are less likely to have children, which means caregiving often falls to spouses who may themselves be aging. Being a sole caregiver can lead to burn-out, especially when access to support systems is limited: older LGBTQ+ caregivers often report experiencing micro-aggressions when they disclose that they are caring for a same-sex partner.
In Washington state alone, Alzheimer’s caregivers contribute about 429 million hours of unpaid care each year, and younger LGBTQ+ people may be carrying a disproportionate load. Less likely to be married and have children, LGBTQ+ younger adults are sometimes assumed to have the time and resources to take on more parent caregiving responsibilities than their heterosexual siblings.
Dr. Charlie Hoy-Ellis suggests that that agism is among the last socially accepted forms of discrimination and—as is often the case in social groups—this socio-cultural norm is amplified and distorted within the queer community. Many young LGBTQ+ people have found a great sense of belonging in a queer community but are painfully rejected from this community as they age. There has been an understandable emphasis on supporting queer youth, but this has come at some expense to midlife and older adults. Now, there is a recognized need for intergenerational programming that addresses the ageist marginalization of queer older adults. Successful strategies offer informal spaces for older and younger LGBTQ+ people to simply talk, share a meal, and potentially gain from one another’s accumulated wisdom and youthful energy.
Throughout his career, Dr. Hoy-Ellis has seen the research landscape evolve when it comes to LGBTQ+ older adults. Although there is now a steady stream of work happening in this field, research was slow to focus on the lives and health of LGBTQ+ older adults. We are now understanding with more clarity that navigating a heterosexist culture causes chronic stress, which in turn leads to higher rates of dementia. Similarly, the long legacy of racism in our country has fueled high rates of Alzheimer’s amongst Black older adults. African American elders are more than twice as likely to develop Alzheimer’s as their white peers, with more than 1 in 5 Black Americans over age 70 living with the disease.
The reasons for this are varied and have their roots in structural racism. Karen Winston, a senior planner at Aging and Disability Services, Seattle Human Services Department, helped launch a program in Seattle that combines two brain health promotion strategies—physical exercise and social connectivity—to celebrate Black history while improving cognitive function. The SHARP (Sharing History through Active Reminiscence and Photo Imagery) Seattle program recognizes that Black communities are disproportionately impacted by gentrification. By encouraging older adults from historically Black neighborhoods to reminisce together on walking routes, this program sparks conversations and memories while providing participants with physical exercise. Developed in Portland by Dr. Raina Croff, this expansion launched in Seattle on June 22. It takes place in Seattle’s Central District.
Dementia affects the parts of the brain that control thought, memory, and language. In the United States, Alzheimer’s affects 6.2 million people aged 65+ and it is estimated that someone new develops the disease every 65 seconds. As our population ages, this will likely accelerate; by 2050, the number of people living with Alzheimer’s is projected to double. Here in Washington, an estimated 120,000 people are currently living with dementia, supported by nearly 300,000 family caregivers. We know that communities are not impacted equally. Understanding how ageism, heterosexism, and racism contribute to brain health and the challenges of caregiving is an important step in advancing equity for older adults.
Contributor Dinah Stephens manages the Age Friendly Seattle initiative. She facilitated the June 23 Civic Coffee. Look for information about past and future Civic Coffees here. To join the Age Friendly Seattle distribution list, send a message to firstname.lastname@example.org.