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Older LGB adults at high risk for co-occurring drug use, mental illness, medical multimorbidity

The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity.

Middle-aged and older LGB adults are at high risk for experiencing co-occurring drug use, mental illness, and/or medical multimorbidity.

This is according to a research – “Co-occurring mental illness, drug use, and medical multimorbidity among lesbian, gay, and bisexual middle-aged and older adults in the United States: a nationally representative study” – by Benjamin H. Han, Dustin T. Duncan, Mauricio Arcila-Mesa & Joseph J. Palamar, and which appeared in BMC Public Health.

The research noted that, as it is, older LGB adults are already “an underserved and understudied population that experience specific health disparities. The intersection of aging and chronic medical disease with a higher risk for substance use and mental illness may place older LGB adults at risk for co-occurring conditions and resulting comorbidity.”

It is therefore necessary to “understand… multimorbidity among older LGB adults” as it “may help inform interventions to reduce disparities in health outcomes.”

For the research, researchers used data from the 2015 to 2017 National Surveys on Drug Use and Health (n = 25,880). They first determined whether sexual orientation was associated with reporting: past-year drug use, mental illness, and/or two or more chronic medical diseases. They then determined whether sexual orientation was associated with reporting co-occurrence of these conditions. This was done using multivariable logistic regression. Analyses were stratified by gender.

The researchers found that compared to heterosexual men, gay men were at increased odds for reporting two or more chronic medical diseases (adjusted odds ratio [aOR] = 2.18, 95% confidence interval [CI] = 1.48, 3.21), and gay (aOR = 1.79, 95% CI = 1.09, 2.93), while bisexual men (aOR = 3.53, 95% CI = 2.03, 6.14) were at increased odds for reporting mental illness. Gay men (aOR = 2.95, 95CI = 1.60, 5.49) and bisexual men (aOR = 2.84, 95% CI = 1.58, 5.08) were at increased odds of reporting co-occurring conditions.

Compared to heterosexual women, bisexual women were at increased odds for past-year drug use (aOR = 4.20, 95% CI = 2.55, 6.93), reporting mental illness (aOR = 1.94, 95% CI = 1.03, 3.67), and reporting co-occurring conditions (aOR = 3.25, 95% = 1.60, 6.62).

Summing up, the researchers stated: “Older sexual minorities… are at heightened risk for the interrelated and compound morbidity from mental illness, drug use, and chronic medical diseases. These disparities are likely due to minority stressors and discrimination along with aging and increasing social isolation. These findings indicate the need to consider how co-occurring conditions can contribute to poor health outcomes in older sexual minority populations and the need for specific interventions within this diverse group.”

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