New Study Sheds Light on Health Disparities of Bi+ Dementia Caregivers

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An estimated 11+ million adults in the U.S. provide unpaid care to family members, friends, and other people living with Alzheimer’s disease and other dementias (ADRD). For ADRD caregivers, the physical, social, emotional, and financial tolls are often substantial; for LGBTQ+ caregivers, these tolls are frequently exacerbated by additional stressors and health disparities experienced by minority populations.

With an estimated 1 in 5 LGBTQ+ adults serving as a caregiver to a family member or friend with a disability or health problem, it’s important to understand the substantial physical, mental, and emotional burdens faced by this population of caregivers. Data indicates LGBTQ+ caregivers report fewer financial and social resources and caregiver supports as well as elevated depressive symptoms and below average health when compared to their non-LGBTQ+ peers. Additionally, they may be caring for someone who does not accept their LGBTQ+ identity, which can increase the psychological impact of caregiving.

Bi+ populations (e.g., bisexual, pansexual, queer) are the largest sexually minoritized group in the U.S., and research suggests they face significant health disparities compared with both monosexual minority (i.e., gay, lesbian) and heterosexual individuals. These elevated levels of minority stress may reflect the compounded negative attitudes bi+ individuals receive from heterosexual people because of their nonconformity to heteronormative standards, as well as from lesbian and gay people because of their nonconformity to monosexual standards.

A new study led by Assistant Professor of Community Health Education Krystal Kittle sheds light on the community of bi+ dementia caregivers. Appearing now in the American Journal of Alzheimer’s Disease and Other Dementias, the study examines this group that has been described as the invisible majority. Furthermore, ADRD caregivers have been characterized as invisible second patients due to the substantial physical, emotional, and social demands of ADRD caregiving. Taken together, the researchers suggest that bi+ ADRD caregivers can be viewed as a twice hidden population. 

In their study, Kittle and colleagues examined associations between minority stress and stress on global health to determine how these associations differed among bi+ and gay/lesbian (g/l) ADRD caregivers. Indeed, their analysis of cross-sectional survey data from LGBTQ+ dementia caregivers revealed that bi+ caregivers reported significantly higher minority stress and lower family quality of life, though better health than g/l caregivers. Additional analyses revealed: higher perceived stress predicted worse health for bi+ but better health for g/l; higher family quality of life predicted better health for both groups, with a stronger effect among bi+ caregivers; and more lifetime discrimination predicted worse health for both groups, with a stronger effect among bi+ caregivers.

“This study sheds much-needed light on bi+ ADRD caregivers, a population often overlooked in caregiving and LGBTQ+ health research, highlighting their distinct experiences with minority stress, caregiving, and health,” write the researchers. “These findings underscore the importance of disaggregating sexual minority groups in caregiving and health research and emphasize the need for inclusive and affirming interventions that address the specific challenges bi+ caregivers face.”