ABSTRACT Objective: To investigate differences in the prevalence of frailty between LGBT+ and non-LGBT+ older adults. Methods: A cross-sectional study involving Brazilians aged 50 and over was performed. The participants were invited to participate in an anonymous online survey between August 2019 and January 2020. The survey was widely distributed in neighborhood associations, day centers, non-governmental organizations, and social media. Those who identified as homosexual, bisexual, pansexual, non-heterosexual, transgender, travesti, or non-binary were grouped as LGBT+. Participants who were both cisgender and heterosexual were categorized as non-LGBT+. Frailty was measured using the FRAIL scale, and the participants were categorized as robust, prefrail, or frail. Generalized ordered logistic models were used to examine the adjusted association between LGBT+ status and frailty according to age and sex. Results: The study sample included 6,693 participants with a median age of 60 years. Overall, 1,332 patients were LGBT+ (19.9%), and 5,361 were non-LGBT+ (80.1%). Pre-frailty or frailty was observed in 656 (49%) LGBT+ participants and 2,460 (46%) non-LGBT+ participants (p=0.03). Multivariate analyses showed that being LGBT+ was independently associated with frailty in female participants aged ≥50 years (OR=1.52, 95%CI=1.08-2.13, p=0.02) and male participants aged ≥60 years (OR=2.83, 95%CI=1.41-5.69, p=0.004). Non-cisgender participants were also more likely to be frail than cisgender participants (OR=2.21, 95%CI=1.42-3.42, p<0.001). Conclusion: LGBT+ status was independently associated with frailty in female adults aged >50 years and males aged > 60 years. More research in this area and inclusive government policies are needed to promote the healthy aging of the LGBT+ population. Objective LGBT nonLGBT+ nonLGBT non non-LGBT Methods crosssectional cross sectional 5 performed 201 2020 associations centers nongovernmental governmental organizations media homosexual bisexual pansexual nonheterosexual, nonheterosexual heterosexual, non-heterosexual transgender travesti nonbinary binary nonLGBT+. scale robust prefrail sex Results 6693 6 693 6,69 Overall 1332 1 332 1,33 19.9%, 199 19.9% , 19 9 (19.9%) 5361 361 5,36 80.1%. 801 80.1% . 80 (80.1%) Prefrailty Pre 65 49% 49 (49% 2460 2 460 2,46 46% 46 (46% p=0.03. p003 p p=0.03 0 03 (p=0.03) ≥5 OR=1.52, OR152 OR 52 (OR=1.52 95%CI=1.082.13, 95CI108213 CI 95%CI=1.08 2.13, 95 08 13 95%CI=1.08-2.13 p=0.02 p002 02 ≥6 OR=2.83, OR283 83 (OR=2.83 95%CI=1.415.69, 95CI141569 95%CI=1.41 5.69, 41 69 95%CI=1.41-5.69 p=0.004. p0004 p=0.004 004 p=0.004) Noncisgender Non OR=2.21, OR221 21 (OR=2.21 95%CI=1.423.42, 95CI142342 95%CI=1.42 3.42, 42 3 95%CI=1.42-3.42 p<0.001. p0001 p<0.001 001 p<0.001) Conclusion >5 population 20 202 669 6,6 133 33 1,3 19.9 (19.9% 536 36 5,3 80.1 8 (80.1% 4 (49 246 2,4 (46 p00 p=0.0 (p=0.03 ≥ OR=1.52 OR15 (OR=1.5 082 95%CI=1.082.13 95CI10821 95CI108 95%CI=1.0 213 2.13 95%CI=1.08-2.1 OR=2.83 OR28 (OR=2.8 415 95%CI=1.415.69 95CI14156 95CI141 95%CI=1.4 569 5.69 95%CI=1.41-5.6 p000 p=0.00 00 OR=2.21 OR22 (OR=2.2 423 95%CI=1.423.42 95CI14234 95CI142 342 3.42 95%CI=1.42-3.4 p<0.00 66 6, 1, 19. (19.9 53 5, 80. (80.1 (4 24 2, p0 p=0. (p=0.0 OR=1.5 OR1 (OR=1. 95%CI=1.082.1 95CI1082 95CI10 95%CI=1. 2.1 95%CI=1.08-2. OR=2.8 OR2 (OR=2. 95%CI=1.415.6 95CI1415 95CI14 56 5.6 95%CI=1.41-5. OR=2.2 95%CI=1.423.4 95CI1423 34 3.4 95%CI=1.42-3. p<0.0 (19. (80. ( p=0 (p=0. OR=1. (OR=1 95%CI=1.082. 95CI1 95%CI=1 2. 95%CI=1.08-2 OR=2. (OR=2 95%CI=1.415. 5. 95%CI=1.41-5 95%CI=1.423. 3. 95%CI=1.42-3 p<0. (19 (80 p= (p=0 OR=1 (OR= 95%CI=1.082 95CI 95%CI= 95%CI=1.08- OR=2 95%CI=1.415 95%CI=1.41- 95%CI=1.423 95%CI=1.42- p<0 (1 (8 (p= OR= (OR 95%CI p< (p

Abstract Objectives: To compare variables of access to healthcare between the LGBT+ population aged 50 and over and those non-LGBT+. Methods: A cross-sectional study was carried out in Brazil through a confidential online questionnaire. The use of the health system was characterized by the number of preventive tests performed and measured by the PCATool-Brasil scale (a 10-point scale in which higher scores were associated with better assistance in healthcare). The association between being LGBT+ and access to health was analyzed in Poisson regression models. Results: 6693 participants (1332 LGBT+ and 5361 non-LGBT+) with a median age of 60 years were included. In the univariate analysis, it was observed not only lower scores on the PCATool scale (5.13 against 5.82, p < 0.001), but a greater proportion of individuals among those classified with the worst quintile of access to healthcare (< 4 points), 31% against 18% (p < 0.001). Being LGBT+ was an independent factor associated with worse access to health (PR = 2.5, 95% CI 2.04‒3.06). The rate of screening cancer, for breast, colon, and cervical cancer was also found to be lower in the LGBT+ population. Conclusion: Healthcare access and health service experiences were worse in the LGBT+ group than in their non-LGBT peers. Inclusive and effective healthcare public policies are essential to promote healthy aging for all. Objectives LGBT 5 nonLGBT+. nonLGBT non LGBT+. non-LGBT+ Methods crosssectional cross sectional questionnaire PCAToolBrasil Brasil 10point point 10 healthcare. . healthcare) models Results 669 1332 (133 536 nonLGBT+ 6 included analysis 5.13 513 13 (5.1 582 82 5.82 0.001, 0001 0.001 , 0 001 0.001) ( points, points points) 31 18 0.001. PR 25 2 2.5 95 2.04‒3.06. 204306 2.04‒3.06 04 3 06 2.04‒3.06) breast colon Conclusion peers all 1 66 133 (13 53 5.1 51 (5. 58 8 5.8 000 0.00 00 2. 9 20430 2.04‒3.0 (1 5. (5 0.0 2043 2.04‒3. 0. 204 2.04‒3 20 2.04‒ 2.04 2.0