Community Support and Cognitive Health among Older LGBTQ+ adults in the Rural U.S. South

• In Event: 20403 - Aging in the Context of Gender and Sexuality

Abstract

Background: Sexual and gender minority (SGM) adults in rural communities face unique challenges as they age, including limited healthcare access, increased social isolation, and a lack of affirming environments. Cognitive decline disproportionately affects SGM populations, particularly those in rural areas, where compounded minority stress may exacerbate cognitive health risks. The Minority Stress Model suggests that chronic exposure to stigma and discrimination contributes to adverse health outcomes. However, community support has been shown to buffer these effects. This study examines how community support influences cognitive health among middle-age and older SGM adults in the rural U.S. South.

Methods: We analyze longitudinal data from the LGBTQ+ Social Network, Aging, and Policy Study (QSNAPS), a panel study of middle-age and older SGM adults (ages 50-76 at Wave 1). Structural equation models assess (1) the direct impact of rural residence on cognitive health, (2) the relationship between rurality and community support, and (3) whether community support mediates cognitive health disparities. Cognitive health is measured by self-rated memory and self-reported cognitive difficulties across three waves. Community support is assessed through an index of affirming relationships and social networks.

Findings: Preliminary results indicate that rural SGM adults experience worse cognitive health outcomes than non-rural peers, while higher levels of community support are associated with better cognitive health. Additionally, community support mediates this relationship—rural SGM adults report lower support, which contributes to cognitive decline.

Discussion: These findings highlight the importance of fostering supportive networks for aging rural SGM populations. Community-based and policy interventions, such as expanding SGM-affirming spaces and healthcare access, may help mitigate cognitive health disparities. Future research should explore how structural and policy factors influence community support and long-term cognitive health trajectories among rural SGM populations.

Authors

• Harry Barbee, Johns Hopkins University

• Tara A. McKay, Vanderbilt University