The study and report would not have been possible without the efforts of the National Council on Aging, AARP, Family Caregiver Alliance, and Old Lesbians Organizing for Change, who helped us disseminate information about the survey and garner respondents from their networks. Last but far from least, our sincere thanks go to Trishala Deb, program officer at the Arcus Foundation, who requested funding and worked with us to implement this grant.

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One in five acutely ill older adults used ETF while hospitalized. Delirium and functional dependency were independent predictors of its introduction. Risks and benefits of enteral nutrition in this particular context need to be further explored.

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Objective: Reports show that LGBT+ people may face several struggles during their endof-life (EOF) preparations, reporting higher rates, for example, of harassment and fear of feeling pain during these moments. We thus aimed to investigate variables related to EOF preparations among LGBT+ people and compare them with heterosexual cisgender individuals. Methods: This is a cross-sectional study in which Brazilians aged 50 or older were invited to answer an anonymous online survey between August 2019 and January 2020. The survey was widely distributed in neighbourhood associations, nongovernmental organizations, and social media. Those who identified as homosexual, bisexual, pansexual, non-heterosexual, transgender, travesti, or non-binary were grouped as LGBT+; cisgender and heterosexual participants were grouped as non-LGBT+. Results: The questionnaire was answered by 6693 participants with a median age of 60 years. Out of all respondents, 1332 were LGBT+ (19.90%) and 5361 were non-LGBT+ (80.10%). Compared to their non-LGBT+ peers, LGBT+ people reported higher rates of loneliness (25.30% vs 16.32%, p < 0.001), fear of dying alone (15.69% vs 9.79%, p < 0.001) or in pain (35.21% vs 25.74%, p < 0.001), and less social support (19.44% vs 13.48%, p < 0.001). Conclusions: Being LGBT+ was associated with challenges and inequalities regarding EOF preparations and discussions. Sexuality and diversity should be addressed in palliative training programs to address the needs of the LGBT+ population and to provide them with a dignified death.

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Background Frailty is associated with several adverse outcomes in older adults, including functional dependency, hospitalizations, and death. However, it has not been determined whether older LGBT + individuals are at a higher risk of frailty than the overall population. Therefore, we aimed to investigate the prevalence of frailty in older LGBT + adults, comparing them with heterosexual-cisgender individuals. Methods A cross-sectional study involving Brazilians aged 50 and over was performed. They were invited to answer an anonymous online-based survey between August 2019 and January 2020. The survey was widely distributed in neighborhood associations, day centers, non-governmental organizations, and social media. Participants were encouraged to forward information about the study to their contacts. Those who identified as homosexual, bisexual, pansexual, non-heterosexual, transgender, travesti, or non-binary were grouped as LGBT+; cisgender and heterosexual participants as non-LGBT+. Frailty was measured using the FRAIL scale, and participants were categorized as robust, prefrail, or frail. We used generalized ordered logistic models to examine the adjusted association between being LGBT + and frailty, according to age group and sex. Results We included 6,693 participants with a median age of 60 years. Overall, 1332 were LGBT+ (19.9%), and 5361, non-LGBT+ (80.1%). Pre-frailty or frailty was found in 656 (49%) LGBT + participants and 2,460 (46%) non-LGBT + participants (p = .03). In our multivariable analyses, we found that being LGBT + was independently associated with frailty in female participants aged ≥ 50 years (OR = 1.52, 95%CI = 1.08–2.13, p = .02) and in male participants aged ≥ 60 years (OR = 2.83, 95%CI = 1.41–5.69, p = .004). Non-cisgender participants were also more likely to be frail than cisgender participants (OR = 2.21, 95%CI = 1.42–3.42, p < .001). Conclusion Being LGBT + was independently associated with frailty in female adults over 50 and males over 60. More research in this area and inclusive government policies are needed to promote healthy aging and address the needs of the LGBT + population.

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