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By NINA TALLEY, MedSpeaks

Earlier this year we read of a growing trend of LGBTQ+ seniors going "back into the closet" out of fear of discrimination as they entered long term care facilities. Shocked and saddened, we researched solutions, hoping to write an article on resources for aging LGBTQ+ individuals. What we found was sobering. There was little information on the population, and even fewer support resources. When we dug a little deeper, we found that this was often because of a simple fact: there is little to no data on LGBTQ+ patient populations. Sexual orientation and gender identity questions are almost never asked upon patient intake, and there is no way to correlate data that is never requested.

So instead we wrote an article highlighting the importance of Sexual Orientation and Gender Identity (SOGI) data collection, and in particular, what that data could mean for sexual minority older adults. We had the pleasure of speaking with Dr. Jason Flatt, assistant professor at the Institute for Health & Aging for the School of Nursing at the University of California San Francisco on the matter, and he detailed the importance of SOGI collection for both trust building and for identifying health disparities. Not included in the article was a longer conversation with Flatt regarding his ongoing research on sexual minority seniors and their rate of dementia risk.

Flatt and his team's findings were recently announced at the 2018 Alzheimer's Association International Conference in Chicago. As the first dementia prevalence data from a large population of lesbian, gay and bisexual older adults, it offers the very first look at the correlation between a life lived as a sexual minority individual and quantifiable health data.

Findings at a glance:

• The crude prevalence for dementia in lesbian, gay, and bisexual older adults was 8 percent, or roughly 1 in 13 lesbian, gay or bisexual seniors in the United States.
• Nearly 70 percent of the lesbian, gay, and bisexual older adults surveyed had hypertension.
• Almost 60 percent of the individuals surveyed had been diagnosed with heart disease.
• 35 percent of the lesbian, gay, and bisexual older adults surveyed had medically diagnosed depression, almost double the rate found in heterosexuals.

So how did Flatt conduct his research if SOGI data is so hard to come by? In 2007 Kaiser Permanente's Northern California Medical Region rolled out a study which asked 200,000 of their patients 60 years of age and older, questions regarding their sexual orientation. By partnering with Kaiser Permanente, Flatt and his team were able to leverage this dataset, and, as an integrated medical center, the data provided was in regard to all medical care given to those surveyed. This provided the clinical background for Flatt's research.

This is a powerful testament to the impact private healthcare institutions can have on the health outlook for minority populations, because it has effectively created the foundational dataset for all senior population sexual minority research to come. Flatt isn't satisfied though. He wants to see gender identity information included in those surveyed as well, and have SOGI data collection integrated into standard intake practices across the board.

"We need to think about really providing more LGBTQ affirming services that are going to meet people where they're at, but also acknowledge who they are." said Flatt. "This may require changing medical forms, or acknowledging families of choice, whether that's a domestic partner or friends."

"They're twice as likely to live alone compared to heterosexuals, so there's a concern around really having support." Flatt continued. "We hope that this data provides some support for thinking about training medical providers around meeting the needs of this community."