Do sexual minorities believe that they die earlier? Results from a large, representative survey.

BACKGROUND: While various consequences of belonging to sexual minorities have been examined - it remains completely unclear whether sexual minorities believe that they die earlier. Thus, our aim was to investigate the association between sexual orientation and expected longevity. METHODS: Data from the German Ageing Survey, a nationally representative sample, were used (year 2014, n = 6,424 individuals; mean age: 63.6 years). It included individuals residing in private households aged 40 years and over in Germany. Sexual orientation (heterosexual; sexual minorities including homosexual, bisexual, or other) served as key independent variable. As outcome, we used the expected life expectancy. In multiple linear regressions it was adjusted for gender, age, education, marital status, labour force participation, BMI, smoking status, alcohol intake, sports activities, physical functioning, self-rated health and the number of chronic conditions. RESULTS: Adjusting for sociodemographic, lifestyle-related and health-related factors, our study showed that sexual minorities reported a lower expected longevity (ß=-0.69, p = .02) compared to heterosexuals. This association remained nearly the same in robustness checks. CONCLUSION: After adjusting for various other factors, our findings showed a lower life expectancy among sexual minorities compared to heterosexuals. Efforts are required to make sexual minorities believe in a high life expectancy (e.g., increased optimism or reduced perceived discrimination) - which in turn can help to increase their actual longevity and successful ageing. Future research is required to explore underlying mechanisms (such as expected stigma in later life).

Multimorbidity patterns in the German general population aged 40 years and over.

AIM: The aim of this study was to identify and describe multimorbidity patterns among middle-aged and older community-dwelling individuals in Germany. Moreover, we aimed to determine potential gender differences in multimorbidity patterns. METHODS: We analysed data from the most recent (sixth) wave (2017) of the large nationally representative German Ageing Survey (DEAS). Altogether n = 6,554 individuals participated, mean age was 62.0 (ranging from 43 to 92 years). Latent Class Analysis was performed to identify multimorbidity patterns, based on 13 chronic conditions and diseases. Multimorbidity was defined as the presence of at least two chronic conditions. RESULTS: Altogether, 53.3% of individuals were multimorbid. We identified and clinically described five multimorbidity patterns: the relatively healthy class (45.1%), the high morbidity class (10.8%), the arthrosis/inflammatory/mental illnesses class (20.6%), the hypertension-metabolic illness class (21.7%), and the cardiovascular/cancer class (1.7%). Our analysis revealed that women compared to men have higher relative risk (IRR = 1.61, 95% CI 1.25-2.06) of being in the arthrosis/inflammatory/mental illnesses class, compared to the relatively healthy class. Furthermore, we found that, depending on which multimorbidity pattern individuals belong to, they differ greatly in terms of socio-demographic factors, health behaviour, and lifestyle factors. CONCLUSIONS: We showed that the many chronic diseases cluster in a non-random way. Five clinically meaningful multimorbidity patterns were identified. Gender differences were apparent only in one class, namely in the arthrosis/inflammatory/mental illnesses class.

Sexual Satisfaction Among Sexual Minority and Heterosexual Middle-Aged and Older Adults.

Background and Objectives: Sexual satisfaction is an important part of sexual health and overall well-being. A large number of older people continue to be sexually active, and many are satisfied with their sex life. However, little is known about whether sexual satisfaction differs according to sexual orientation. Therefore, the aim of the study was to investigate whether sexual satisfaction differs according to sexual orientation in later life. Research Design and Methods: The German Ageing Survey is a nationally representative study of the German population aged 40+. In the third wave (2008), data on both sexual orientation (heterosexual, homosexual, bisexual, other) and sexual satisfaction (1-very dissatisfied to 5-very satisfied) were collected. Multiple regression analyses with sampling weights were performed (stratified by age: 40-64; 65+). Results: We included 4,856 individuals in our analysis (mean age 57.6 ± 11.6; 40-85 years, 50.4% were women, 92.3% (n = 4,483) were heterosexual, and 7.7% (n = 373) were sexual minority adults). In sum, 55.9% of heterosexual individuals and 52.3% of sexual minority adults were satisfied or very satisfied with their sex life. Multiple regression analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged (ß = 0.07; p = .45) and older adults (ß = 0.01; p = .87). Higher sexual satisfaction was associated with lower loneliness scores, partnership satisfaction, importance of sexuality and intimacy, and better health status. Discussion and Implications: Our analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged and older adults. Lower loneliness, better health status, and partnership satisfaction significantly contributed to higher sexual satisfaction. Approximately 45% of older individuals (aged 65 years and older), regardless of their sexual orientation, were still satisfied with their sex life.

Prevalence and Determinants of Depressive and Anxiety Symptoms among Transgender People: Results of a Survey.

OBJECTIVES: The aim was to investigate the prevalence of probable depression and probable anxiety and to investigate the determinants of depressive symptoms and anxiety symptoms among transgender people. METHODS: In this "Transgender Survey" (n = 104) we included transgender people who had joined self-help groups to obtain and share information about the gender-affirming surgeries performed at the Division of Plastic, Reconstructive and Aesthetic Surgery at the University Medical Center Hamburg-Eppendorf. Data collection took place between April and October 2022. To measure probable depression, the patient health questionnaire-9 was used. The generalized anxiety disorder-7 was used to quantify probable anxiety. RESULTS: The prevalence of probable depression was 33.3% and it was 29.6% for probable anxiety. Multiple linear regressions showed that both more depressive symptoms and anxiety symptoms were significantly associated with younger age (ß = -0.16, p < 0.01; ß = -0.14, p < 0.01), being unemployed (e.g., full-time employed compared to unemployment: ß = -3.05, p < 0.05; ß = -2.69, p < 0.05), worse self-rated health (ß = -3.31, p < 0.001; ß = -1.88, p < 0.05), and having at least one chronic disease (ß = 3.71, p < 0.01; ß = 2.61, p < 0.05). CONCLUSIONS: Remarkably high prevalence rates were identified among transgender people. Furthermore, risk factors of poor mental health (e.g., unemployment or younger age) were identified-which can help to address transgender people at risk for poor mental health.

Sexual Orientation and Psychosocial Factors in Terms of Loneliness and Subjective Well-Being in Later Life.

BACKGROUND AND OBJECTIVES: The aim of our study was to fill the gap in knowledge regarding the association between sexual orientation and psychosocial outcomes (loneliness and subjective well-being) based on nationally representative samples. RESEARCH DESIGN AND METHODS: Cross-sectional data collected in 2017 were taken from a nationally representative sample of individuals in the second half of life (>40 years) in Germany (n = 4,785, average age 66.4 years, standard deviation [SD]: 10.5 years). Outcomes were assessed using well-established tools (life satisfaction: Satisfaction with Life Scale; positive and negative affect: Positive and Negative Affect Schedule; loneliness: De Jong Gierveld Loneliness Scale). Sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual, and other). Analyses were adjusted for socioeconomic factors, lifestyle-related factors, and health-related factors. RESULTS: In total, around 7.8% of respondents belonged to sexual minorities. Adjusted for various several socioeconomic, lifestyle-related and health-related covariates, linear regressions showed that sexual minority older adults reported higher loneliness scores (ß = 0.07, p < .05), whereas sexual orientation was not associated with subjective well-being (life satisfaction, as well as positive and negative affect). Furthermore, our analysis showed that gender, age, marital status, and depressive symptoms were consistently associated with loneliness and subjective well-being. DISCUSSION AND IMPLICATIONS: In accordance with minority stress theory, our study showed that sexual minority older adults report higher loneliness scores. This finding is important as loneliness has become widely acknowledged as a new geriatric giant, which could increase, for example, the risk of morbidity and mortality. Moreover, reducing loneliness is important for successful aging.

Long-Term Care Preferences and Sexual Orientation-A Systematic Review and Meta-Analysis.

OBJECTIVES: The number of sexual and gender minority older adults who require long-term care is steadily increasing. The purpose of this systematic review and meta-analysis was to synthesize the evidence related to preference for long-term care with regard to sexual orientation and gender identity. DESIGN: Systematic review and meta-analysis. SETTING AND PARTICIPANTS: We searched PubMed/MEDLINE, Ovid/PsycINFO, and Web of Science from inception to July 2020 (updated in July 2021). Search terms embraced 3 themes (1) sexual and gender minorities, (2) long-term care, and (3) preferences. Quantitative studies of the adult population were included. METHODS: Screening, data extraction, and quality assessment followed the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. The proportions were pooled using meta-analysis and random effects models. RESULTS: A total of 17 articles were included out of 5944 studies of potential relevance. The perception of nursing homes (NHs) that emerges from these studies is predominantly negative for heterosexuals and lesbian, gay, bisexual and trans (LGBT) individuals (n = 11). Across 6 studies (10 outcomes), the pooled estimate for the proportion of individuals with a preference to move into a NH was 10.6% [95% confidence interval (CI) 7.88%‒13.22%, I2 = 97.4%]; 13.7% (95% CI 8.6%‒18.7%) for LGBT individuals and 7.3% (95% CI 3.14%‒11.50%) for heterosexuals. LGBT-friendly NHs were preferred by between 55% and 98% of LGBT respondents. Informal care provided by partner or family was one of the preferred options (n = 6). It was preferred by 33% to 70% of various groups of LGBT respondents. CONCLUSIONS AND IMPLICATIONS: The preference to move into a NH is relatively low among both heterosexuals and sexual and gender minority adults. Findings showed negligible differences in preferences to move into a NH between heterosexuals and sexual and gender minorities. LGBT-friendly long-term care facilities where every member feels welcomed and not discriminated against seem to be one of the favorable long-term care choices among LGBT individuals. This knowledge is important to inform nursing services and policy makers about the preferred long-term care options. Providing LGBT-friendly facilities is usually less expensive than providing care in newly created LGBT-only facilities.

Do Sexually Satisfied Individuals Think That They Live Longer? Results from the German Ageing Survey.

The aim of this study was to determine the association between sexual satisfaction and expected longevity among middle-aged and older adults (also stratified by sex). Data were taken from the German Ageing Survey (year 2011; n = 3231)­a nationally representative sample of community-dwelling individuals ≥ 40 years in Germany. A widely used question was used to quantify sexual satisfaction. Furthermore, the expected life expectancy served as an outcome measure. After adjusting for various covariates, multiple linear regressions showed that sexual satisfaction was associated with higher expected longevity among the total sample (ß = 0.28, p < 0.05). Moreover, it was associated with higher expected longevity among women (ß = 0.48, p < 0.05), but not men. In conclusion, adjusting for several covariates, our results showed that there is an association between sexual satisfaction and higher expected longevity, particularly in women. Efforts to increase sexual satisfaction may thus also contribute to expected longevity which, in turn, can be beneficial for actual longevity.

Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts.

Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods: We used harmonized data from three large cohort studies from Germany ("Healthy Aging: Gender-specific trajectories into the latest life"; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels' services. Logistic regression models were used, adjusting for important sociodemographic variables. Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels' services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24-1.76]; p < 0.001), whereas they had lower odds of using meals on wheels' services (OR = 0.64, 95% CI: [0.42-0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87-1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson's disease) and walking impairments. Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels' services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care services may contribute to maintaining autonomy and independence in old age.

Depressive Symptoms and Healthcare Utilization in Late Life. Longitudinal Evidence From the AgeMooDe Study.

Objective: The aim of this study was to investigate the longitudinal impact of depressive symptoms on utilization of healthcare in terms of GP visits as well as specialist visits and hospital admission in late life among community-dwelling individuals. Methods: Longitudinal data (baseline and follow-up) were derived from the German multicentre, prospective cohort study "Late-life depression in primary care: needs, health care utilization and costs" study (AgeMooDe). At baseline, n = 1,230 patients aged 75 years and older were recruited from primary care practices. Main outcomes of interest were use of health care services: the number of GP visits, the number of medical specialist visits, and hospital admission. We used the Geriatric Depression Scale (GDS-15) to measure depression. Outcomes were analyzed with multilevel random intercept negative binominal regression and logistic random-effects models. Results: At baseline (n = 1,191), mean age was 80.7 (SD 4.6) years, 62.9% were female, and 196 individuals (16.5%) had depression (GDS-15 ≥6). Our longitudinal analyses indicated that older individuals with more depressive symptoms visited their GP more often (IRR=1.03; CI [1.01-1.04], p < 0.001), were visiting medical specialists more frequently (IRR=1.03; CI [1.01-1.04], p < 0.01), and had higher odds of being hospitalized (OR=1.08; CI [1.02-1.13], p < 0.01). Conclusions: Based on this large longitudinal study we showed that, after adjustment for important covariates, older individuals with more depressive symptoms had higher health care utilization over time. They visited their GP and specialists more frequently and they had higher odds of being hospitalized. This may suggest that higher utilization of specialist care and increased likelihood of being hospitalized may be also attributable to unspecific symptoms or symptoms that are elevated through depressive symptoms.

Factors Contributing to Persistent Frequent Attendance in Primary Care Among the Oldest Old: Longitudinal Evidence From the AgeCoDe-AgeQualiDe Study.

Objective: Since there is a lack of longitudinal studies in this area, our aim was to identify the determinants of persistent frequent attendance in primary care among the oldest old in Germany. Methods: Longitudinal data (follow-up wave 7-9) were taken from the multicenter prospective cohort "Study on needs, health service use, costs, and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe), covering primary care patients ≥ 85 years (FU7 n = 741, mean age 88.9 years (SD 2.9; 85-100)). Persistent frequent attenders of general practitioner (GP) services (the patients in the top decile of the number of GP consultations in two or more consecutive waves) were our main outcome of interest. Logistic random-effects models were used. Results: Our analysis included 1,891 observations (766 individuals). Across three waves, we identified 56 persistent frequent attenders. Results of random-effects logistic regressions showed that the odds of being persistent frequent attender were higher for widowed individuals (OR = 4.57; 95% CI [1.07-19.45]). Moreover, a one-point increase in the frailty score and having one more chronic condition increased the odds of being a persistent frequent attender by 68% (OR =1.68; 95% CI [1.05-2.69]) and 23% (OR=1.23, 95% CI [1.05-1.44]), respectively. Conclusion: Our study stressed the longitudinal association between frailty and widowhood as well as chronic diseases and persistent frequent attendance among the oldest old in Germany.

The Big Five personality traits and regularity of lifetime dental visit attendance: evidence of the Survey of Health, Ageing, and Retirement in Europe (SHARE).

BACKGROUND: Regular dental visits are essential for the prevention, early detection and treatment of worldwide highly prevalent oral diseases. Personality traits were previously associated with treatment compliance, medication adherence and regular doctor visits, however, the link between personality traits and regular dental visit attendance remains largely unexplored. Thus, the objective of this study is to clarify this link. METHODS: Data (wave 7) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used, focusing on Germany (n = 2822). Personality was assessed using the 10-item Big Five Inventory (BFI-10). Regular dental visits were assessed. Multiple logistic regressions were used, adjusting for various covariates. RESULTS: Majority of the participants (84%) reported to attend regular dental visits during lifetime. Regularity of lifetime dental visit attendance was positively and significantly associated with increased extraversion [OR 1.13, 95% CI (1.01-1.26)], increased conscientiousness [OR 1.26, 95% CI (1.10-1.44)], and increased openness to experience [OR 1.12, 95% CI (1.01-1.26)]. However, there was a lack of association with agreeableness and neuroticism. Moreover, the outcome measure was positively associated with younger age, being female, born in Germany, being married, higher education, being retired (compared to being homemaker), whereas it was not associated with obesity or chronic diseases. CONCLUSIONS: Identification of personality traits that are associated with regular dental visits can support prevention, screening and clinical management of oral diseases. Further research in this field may facilitate the development and increase the incorporation of individualized concepts to enhance patient compliance and attendance, and thus the provision of oral and dental care services.

Regular childhood dental visits, health-related factors and quality of life in later life.

Purpose To examine the relationship between regular childhood dental visits, and health status and quality of life in later life. Methods Cross-sectional data from wave 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used (n = 2,368; mean age was 66.2 (SD: 9.1, ranging from 50 to 95 years). We focused on data from Germany. Health-related outcome measures (i.e. functional status, cognitive functioning, and self-rated health) were quantified using established tools. Quality of life was assessed using the well-recognized CASP-12. Results In sum, 65.8% of the individuals had regular childhood dental visits. Multiple linear regressions showed that regular childhood dental visits were not associated with present functional status, cognitive functioning or with self-rated health. However, regular childhood dental visits were associated with better quality of life. Moreover, being married, tertiary education (reference: primary education) and not being obese were each associated with higher cognitive functioning, better self-rated health and better quality of life. Conclusion: Regular childhood dental visits were associated with better quality of life. Future studies are required to elucidate the underlying causes.

Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study.

INTRODUCTION: Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the oldest old longitudinally. METHODS: Longitudinal data (follow-up [FU] wave 7-9) were gathered from a multicenter prospective cohort study ("Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+]," AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85-100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. RESULTS: Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00-0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04-1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61-49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11-0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. CONCLUSION: Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

Postponed Dental Appointments Due to Costs Are Associated with Increased Loneliness-Evidence from the Survey of Health, Ageing and Retirement in Europe.

As is already well known, demographic changes will presumably lead to a rising number of old aged individuals and loneliness is a tremendous concern in aging populations. Poor health can be a potential consequence of loneliness, as well as a determining factor. Thus, the objective of the current study was to determine whether postponed dental appointments due to costs affect loneliness longitudinally. Focusing on Germany, data from two waves (waves 5 and 6) of the "Survey of Health Ageing, and Retirement in Europe" (SHARE) were analyzed (n = 7703). The three-item loneliness scale (modified version of the revised UCLA Loneliness scale) was used to quantify loneliness. The presence of postponed dental appointments due to costs in the past 12 months (no; yes) served as a key independent variable. Socioeconomic factors as well as health-related factors were adjusted in the longitudinal regression analysis. After adjusting for confounding variables, regression analyses revealed that loneliness increased with decreases in self-rated health among men. Among women, loneliness increased when self-rated health decreased, when fewer chronic diseases and postponed dental appointments due to costs were reported. Among older women, postponed dental appointments due to costs are associated with feelings of loneliness. The study results add evidence that proper dental care (i.e., regular and appropriate visits to the dentist) is vital not only to one's oral health, but also plays a role in one's physical and emotional health.

Do postponed dental visits for financial reasons reduce quality of life? Evidence from the Survey of Health, Ageing and Retirement in Europe.

BACKGROUND: There is a lack of studies investigating the impact of postponed dental visits due to financial constraints on quality of life. AIMS: The aim of this study was to identify whether these factors are associated longitudinally. METHODS: Data were derived from waves 5 and 6 of the "Survey of Health Ageing and Retirement in Europe" (SHARE). The analysis focused on Germany (n = 7506). The widely used CASP-12 was used to quantify the quality of life. Postponed dental visits for financial reasons in the preceding 12 months (no, yes) were used as the main explanatory variable. Socioeconomic and health-related covariates were included in regression analysis. RESULTS: Gender stratified regression analysis showed that quality of life decreased with the presence of postponed dental visits due to financial reasons in men. Furthermore, quality of life decreased with the worsening of self-rated health in both men and women. The outcome measure was not associated with age, marital status, income, and chronic diseases in both sexes. DISCUSSION: Study findings suggest that postponing dental visits due to financial constraints contributes to a decreased quality of life among older men. CONCLUSION: Efforts to avoid these circumstances might help to maintain the quality of life in older men.

Sexual satisfaction of middle-aged and older adults: longitudinal findings from a nationally representative sample.

BACKGROUND: whilst previous studies have investigated the determinants of sexual satisfaction (i) using longitudinal data or (ii) among older adults, only a few studies have done both at the sametime. OBJECTIVE: the purpose of this study was to investigate the determinants of sexual satisfaction longitudinally among middle-aged and older adults. DESIGN: nationally representative longitudinal study (German Ageing Survey-DEAS). SETTING: community-dwelling individuals in Germany. Data drawn from three waves (2002, 2008, 2011). SUBJECTS: individuals aged 40-95 (36.9% age group 65+). At wave 2 in the year 2002, n = 3,843 individuals took part. METHODS: well-established and widely used scales were used to quantify the independent variables. We included variables such as sociodemographic factors, self-rated health, physical functioning, depression and loneliness in our analysis. Sexual satisfaction was our outcome measure. Results were stratified by age (40-64, 65+). To take into account the multilevel data structure, we used random coefficient models. RESULTS: random-effects regressions showed that increased sexual satisfaction was consistently associated with the following variables in both age groups: lower number of physical illnesses, ß = -0.03, P < 0.001 (betas coefficients given for individuals 65 years and over); better self-rated health, ß = -0.06, P < 0.001; absence of depression, ß = -0.16, P < 0.01; and higher importance of sexuality and intimacy, ß = 0.08, P < 0.001. Moreover, sexual satisfaction was associated with having a partner: ß = 0.16, P < 0.001; living with a partner in the same household, ß = 0.26, P < 0.001; and a lower score of loneliness, ß = -.28, P < 0.001. In contrast, sexual satisfaction was, for example, not associated with cognitive functioning. CONCLUSIONS: the most surprising findings were that among both middle-aged and older adults, almost the same determinants (with exception of sociodemographic factors) were associated with satisfaction with sexlife.

Planning to move into a nursing home in old age: does sexual orientation matter?

BACKGROUND: Qualitative studies showed that community-dwelling Lesbian, Gay, Bisexual and Transgender (LGBT) individuals perceive that LGBT individuals are discriminated against in nursing homes (NHs) due to their sexual orientation. Therefore, the objective of this quantitative, population-based study was to investigate the link between sexual orientation and planning to move into a NH in old age. METHODS: Cross-sectional data from the most recent sixth wave of the nationally representative German Ageing Survey (n = 4,645) were used. The sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual and other). Planning to move into a NH in the future (yes/no) was our outcome measure. Multiple logistic regressions were performed (adjusting for various socioeconomic, psychosocial and health-related covariates). RESULTS: Regressions showed that sexual orientation was not significantly associated with plans to move to a NH. Preference to move into NH were consistently positively associated with age (OR: 1.04 (1.02-1.07), not having at least one child (OR: 2.17 (1.41-3.36)), high education (OR: 3.82 (1.32-11.11)), greater loneliness (OR: 1.44 (1.05-1.96)) and worse physical functioning (OR: 0.99 (0.98-1.00)). CONCLUSIONS: Unexpectedly, our results showed that plans to move to a NH did not differ significantly between heterosexual individuals and sexual minorities. This indicates that sexual orientation does not play a significant role in shaping preferences around moving into a NH 'in general'. In contrast, other factors like age, greater loneliness and worse physical functioning were important. Those factors should be taken into account when shaping and updating policies on nursing homes.

[The Proportion of Sexual Minorities (LGB) Among Community-Dwelling Older Individuals in Germany and the Potential Association Between Sexual Orientation and Depressive Symptoms]. / Der Anteil sexueller Minoritäten in der älteren Wohnbevölkerung in Deutschland und potenzielle Assoziation zwischen der sexuellen Orientierung und depressiven Symptomen.

OBJECTIVE: To estimate the size of the sexual minorities population in the community-dwelling elderly population in Germany, and to identify whether there is a link with sexual minority status and depressive symptoms. METHODS: Data were taken from the most recent sixth wave (year 2017) of the German Ageing Survey (n = 5,133). Average age was 66,1 years (43-90 years). Depressive symptoms were quantified using the 15-item version of the Center for Epidemiologic Studies Depression Scale (CES-D). Sexualities of heterosexual, homosexual and bisexual were identified. In the analyses we included the following covariates: age, sex, partnership status, place of residence, subjective health, physical functioning (short scale SF-36). RESULTS: Among community-dwelling individuals 40 years and over, 92.8 % identify themselves as heterosexuals and 7.2 % as gender and sexual minorities (1.7 % bisexual, 1.1 % homosexual, and 4.3 % belong to the group "others"). Both bivariate analysis and multiple linear regressions showed no significant association between sexual orientation and depressive symptoms. CONCLUSION: Our study findings suggest that there is no significant association between sexual orientation and depressive symptoms among community-dwelling older adults.

Determinants of dental treatment avoidance: findings from a nationally representative study.

BACKGROUND: Oral health care of older adults is of rising importance due to ongoing demographic changes. There is a lack of studies examining the determinants of dental treatment avoidance in this age group. Therefore, the objective of this study was to identify those determinants. METHODS: Cross-sectional data were drawn from the second wave (year 2002) of the German Ageing Survey which is a population-based sample of community-dwelling individuals ≥ 40 years in Germany (n = 3398). Dental treatment avoidance was quantified using the question "Did you need dental treatments in the past twelve months, but did not go to the dentist?" [no; yes, once; yes, several times]. Socioeconomic and health-related determinants were adjusted for in the analysis. Multiple logistic regressions were performed. RESULTS: In terms of need, 6.7% of individuals avoided dental treatment in the preceding twelve months. Multiple logistic regressions revealed that dental treatment avoidance was associated with younger age (total sample [OR 0.978; 95% CI 0.958-0.998] and men [OR 0.970; 95% CI 0.942-0.999]), unemployment (total sample [OR 1.544; 95% CI 1.035-2.302] and men [OR 2.004; 95% CI 1.085-3.702]), lower social strata (women [OR 0.814; 95% CI 0.678-0.977]), increased depressive symptoms (men [OR 1.031; 95% CI 1.001-1.062]), and increased physical illnesses (total sample [OR 1.091; 95% CI 1.006-1.183] and men [OR 1.165; 95% CI 1.048-1.295]). The outcome measure was not associated with income poverty, marital status and physical functioning. CONCLUSIONS: The present study highlights the association between dental treatment avoidance and different socioeconomic and health-related factors. These results suggest that it is necessary to promote the importance of dental visits.