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Canada is experiencing population aging, and given the heterogeneity of older adults, there is increasing diversity in late life. The purpose of this study was to help fill the research gaps on LGBT aging and end-of-life. Through focus groups, we sought to better understand the lived experience of older LGBT individuals and to examine their concerns associated with end-of-life. Our analysis highlights the idea that identifying as LGBT matters when it comes to aging and end-of-life care. In particular, gender identity and sexual orientation matter when it comes to social connections, in the expectations individuals have for their own care, and in the unique fear related to staying out of the closet and maintaining identity throughout aging and end-of-life. This study underscores the need to consider gender identity and sexual orientation at end-of-life. In particular, recognition of intersectionality and social locations is crucial to facilitating positive aging experiences and end-of-life care.

Lesbian, gay, bisexual, and transgender (LGBT) older adults face a number of challenges with respect to access to healthcare especially towards end-of-life. Through a systematic search and scoping review of the literature, we sought to answer two related research questions. In particular, the purpose of this scoping review was to determine the healthcare needs of LGBT older adults nearing end-of-life as well as the factors that contribute to a good death experience among older adults who identify as LGBT. A systematic search of electronic databases for articles published between 2005 and 2016 as well as screening for relevance resulted in 25 results. The data were charted and grouped according to the themes of: social support and chosen family, intimacy, health status, fear of discrimination and lack of trust, lack of knowledge and preparedness, and cultural competence in the healthcare system. The results suggest a role for health and social service workers in contributing to a positive care experience for LGBT older adults by becoming knowledgeable about the unique needs of this population and being unassuming and accepting of individuals' sexuality. Many of the articles reviewed collected data outside of Canada, limiting generalizability and highlighting a need for Canadian data on LGBT aging and end-of-life.

This study sought to predict driving performance of drivers with Alzheimer's disease (AD) using measures of attention, visual processing, and global cognition. Simulated driving performance of individuals with mild AD (n = 20) was contrasted with performance of a group of healthy controls (n = 21). Performance on measures of global cognitive function and specific tests of attention and visual processing were examined in relation to simulated driving performance. Strong associations were observed between measures of attention, notably the Test of Everyday Attention (sustained attention; r = -.651, P = .002) and the Useful Field of View (r = .563, P = .010), and driving performance among drivers with mild AD. The Visual Object and Space Perception Test-object was significantly correlated with the occurrence of crashes (r = .652, P = .002). Tests of global cognition did not correlate with simulated driving outcomes. The results suggest that professionals exercise caution when extrapolating driving performance based on global cognitive indicators.

Background Social determinants of health are well linked to adverse health outcomes, but less is known about how they relate to migraine. While much attention has been given to the role of modifiable lifestyle factors which may mitigate risk of migraine, the role of physical activity in headache management is not yet understood. Objectives The purpose of this study was to explore the relationship between social determinants of health, health behaviors, and migraine prevalence in a sample of the Canadian population aged 45‐85 years. Methods In this cross‐sectional analysis of baseline data from the Canadian Longitudinal Study on Aging, respondents were between 45 and 85 years of age and migraine was self‐report of physician diagnosis. Analyses were stratified by sex/gender (nwomen = 22,176, nmen = 21,549). Results The weighted prevalence of migraine for men and women was 7.5% and 19.6%, respectively. There were relationships between social determinants of health and migraine for both men and women. Notably, higher perceived social status was associated with a 3% reduced odds of migraine among women (OR = 0.97, 95% CI: 0.95, 0.98, P < .001). Gay and bisexual men had 50% higher odds of migraine compared to heterosexual men (OR = 1.50, 95% CI: 1.13, 1.99, P = .005). Some forms of physical activity were associated with reduced odds of migraine for women: walking for 30 minutes but less than 1 hour (OR = 0.87, 95% CI: 0.78, 0.96, P = .005), light sports for less than 30 minutes (OR = 0.86, 95% CI: 0.73, 1.00, P = .048), and 1 hour but less than 2 hours (OR = 0.85, 95% CI: 0.74, 0.97, P = .018), strenuous sports for 30 minutes but less than 1 hour (OR = 0.79, 95% CI: 0.71, 0.89, P < .001), and 1 hour but less than 2 hours (OR = 0.82, 95% CI: 0.73, 0.92, P = .001). Men who engaged in daily walking as a form of leisure time physical activity had higher odds of migraine: walking less than 30 minutes (OR = 1.21, 95% CI: 1.01, 1.45, P = .042), 2 hours but less than 4 hours (OR = 1.42, 95% CI: 1.11, 1.80, P = .005), and 4 hours or more (OR = 1.65, 95% CI: 1.18, 2.31, P = .004). Conclusions Social determinants of health are associated with migraine prevalence for both men and women. Physical activity is a modifiable lifestyle factor which merits further exploration as an intervention option for migraine headaches in aging samples, especially among older women. Greater odds of migraine among older men who walked for exercise may be explained by reverse causality.

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This study examined the role of impaired divided attention and speed of processing in traumatic brain injury (TBI) drivers in high-crash-risk simulated road events. A total of 17 TBI drivers and 16 healthy participants were exposed to four challenging simulated roadway events to which behavioral reactions were recorded. Participants were also asked to perform a dual task during portions of the driving task, and TBI individuals were administered standard measures of divided attention and reaction time. Results indicated that the TBI group crashed significantly more than controls (p < .05) and that dual-task performance correlated significantly with crash rate (r = .58, p = .05).

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