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Social and Health Disparities Drive Brain Aging in Latin America

by Ella

A recent study published in The Lancet Global Health sheds light on the key factors influencing healthy brain aging across Latin America, focusing on countries such as Brazil, Colombia, Chile, Uruguay, and Ecuador. The research highlights that social and health disparities, rather than demographic characteristics, play a significant role in explaining differences in cognitive and functional abilities in older adults.

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Background

Encouraging healthy brain aging is a priority for many nations, as it allows individuals to live fulfilling lives regardless of age. Brain health is generally assessed through functional and cognitive abilities, which can be influenced by a variety of factors, including gender, age, education, socioeconomic status, lifestyle, and mental health.

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Regional differences in risk factors for brain aging have been observed, and in Latin America, disparities in education and socioeconomic status appear to have a greater impact than factors like age or gender. Brazil, with its vast socioeconomic inequalities and reliance on government-provided healthcare, presents a crucial case for understanding how these disparities influence brain aging, especially given the high prevalence of conditions such as dementia in the country.

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Study Details

In this large-scale study, researchers utilized machine learning techniques to identify risk factors for cognitive and functional decline in older adults. The study included data from over 41,000 individuals across five Latin American countries: Brazil, Colombia, Chile, Uruguay, and Ecuador. Participants, with an average age of 70.8, were assessed for cognitive skills (e.g., temporal orientation, verbal fluency, and word retrieval) and functional ability (e.g., the ability to perform daily activities such as dressing and grooming).

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Researchers hypothesized that health and social inequalities, rather than demographic characteristics, would significantly influence brain aging in these populations. The study also aimed to examine whether Brazil’s diverse demographic profile could reveal unique factors affecting brain aging.

The study included 1,301 participants from Chile, 1,450 from Uruguay, 5,235 from Ecuador, and 9,412 from Brazil. Uruguay and Chile were classified as high-income countries, while Brazil, Colombia, and Ecuador were categorized as low- and middle-income countries.

Key Findings

The study found several interesting regional differences in risk factors and outcomes:

  • Brazil: Despite having younger participants with higher educational attainment, Brazil had the lowest scores for both cognitive and functional abilities. The most important contributing factors to cognitive decline in Brazil were educational level, mental health symptoms, physical inactivity, smoking, socioeconomic status, and age. For functional ability, mental health issues, falls, heart disease, physical activity, diabetes, alcohol consumption, hypertension, education, and social isolation played significant roles.

  • Ecuador: Smoking rates were highest in Ecuador, followed by Uruguay. Mental health symptoms, physical inactivity, and socioeconomic factors were similarly influential in this country.

  • Chile and Uruguay: These countries, with higher average income levels, displayed different risk profiles compared to the other nations. In these higher-income countries, the influence of education and physical activity on brain health was notable.

One of the striking findings was that in Brazil, cognitive decline was more pronounced in the northern regions compared to the southeast, south, and central-western areas. Similarly, living in the northeast region of Brazil was identified as a risk factor for functional decline.

Conclusions

The study underscores the crucial role of mental health in cognitive and functional decline across all the countries studied, with socioeconomic status, education, and physical activity also emerging as significant predictors. Smoking and alcohol consumption were found to have a moderate impact on brain aging.

While the findings are important, they are based on self-reported data and limited screening tools for cognitive and functional ability. Despite these limitations, the study provides valuable insights into the social and health-related disparities that drive brain aging in Latin America.

The researchers emphasize that interventions to promote healthy brain aging in these countries should be tailored to address the specific regional disparities and consider the complex interplay of social and health factors. Public health initiatives should focus on improving education, mental health support, physical activity, and reducing socioeconomic inequalities to help mitigate cognitive decline and improve brain health outcomes across Latin America.

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