Religious and spiritual journeys of LGBT older adults in rural Southern Appalachia

Global rural health disparities in Alzheimer's disease and related dementias: State of the science

INTRODUCTION

Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors specific to rural areas that contribute to ADRD is an essential first step in understanding the complex interplay between various barriers and facilitators.

METHODS

An interdisciplinary, international group of ADRD researchers convened to address the overarching question of: "What can be done to begin minimizing the rural health disparities that contribute uniquely to ADRD?" In this state of the science appraisal, we explore what is known about the biological, behavioral, sociocultural, and environmental influences on ADRD disparities in rural settings.

RESULTS

A range of individual, interpersonal, and community factors were identified, including strengths of rural residents in facilitating healthy aging lifestyle interventions.

DISCUSSION

A location dynamics model and ADRD-focused future directions are offered for guiding rural practitioners, researchers, and policymakers in mitigating rural disparities.

HIGHLIGHTS

Rural residents face heightened Alzheimer's disease and related dementia (ADRD) risks and burdens due to health disparities. Defining the unique rural barriers and facilitators to cognitive health yields insight. The strengths and resilience of rural residents can mitigate ADRD-related challenges. A novel "location dynamics" model guides assessment of rural-specific ADRD issues.

Meaning in Life, Death Anxiety, and Spirituality in the Lesbian, Gay, and Bisexual Community: A Scoping Review

The changes in people's way of life through the years raise questions on how they address existential needs and concerns, particularly those related to life and death and spiritual connections. Through a scoping review, we surveyed studies on meaning in life, death anxiety, and spirituality within the lesbian, gay, and bisexual (LGB) community. We determined the extent to which these variables have been studied among LGB participants. A total of 28 eligible articles were reviewed. Six studies were found about meaning in life, five studies about death anxiety, and 16 studies about spirituality. Results suggest that meaning in life was derived from experiences related to parenthood, couplehood, and work satisfaction. Studies on death anxiety among LGB participants, which date back to the 1980 and 1990s, indicated the need to conduct present studies in this area. The review showed that LGB members distinguished between spirituality and religion, giving them more positive recognition of the former than the latter. The forms of spiritual expression were anchored to religious practices, for some, and other expressions of belief and faith outside the confines of formally established religions. Spiritual expressions generally accorded the LGB members direction and satisfaction in life. Not all segments of the LGB community were represented in the studies. The available studies, dominantly quantitative, centered only on the LGB experience. Target age groups varied across the studies. The review indicates that future studies can work on exploring these existential factors considering the emerging contexts and paradigms. Future research can focus on determining what factors contribute to meaning in life, given the changes in time.