Ciciliati Aline Maria Macagnan, Leite Renata Elaine Paraizo, Grinberg Lea T, Pasqualucci Carlos Augusto, Paes Vitor Ribeiro, Justo Alberto Fernando Oliveira, Ferretti-Rebustini Renata Eloah de Lucena, Ferrioli Eduardo, Suemoto Claudia Kimie
Division of Geriatrics, University of São Paulo Medical School, São Paulo, Brazil.
Department of Pathology, University of São Paulo Medical School, São Paulo, Brazil.
J Alzheimers Dis Rep. 2025 Apr 16;9:25424823251336247. doi: 10.1177/25424823251336247. eCollection 2025 Jan-Dec.
Cognitive impairment and disability are frequent among the oldest-old population, particularly in low- and middle-income countries (LMIC), where this population is rapidly increasing. However, studies on people aged 90 or older are scarce in these settings. Here we analyze the characteristics of the Brazilian Very Old 90+ (BRAVO 90+) study, a population-based sample of 90+ older adults who died in Sao Paulo, Brazil.
To describe clinical and functional characteristics and investigate factors associated with cognitive impairment in Brazilian adults 90 years or older.
Data were collected at the time of death. Postmortem cognitive evaluation regarding cognitive abilities three months before death was performed using the Clinical Dementia Rating (CDR) scale. We investigated factors associated with cognitive impairment selected by a Lasso regression.
Among 409 participants (mean age = 94 ± 3 years; 72% women; 69% white; average education = 3.3 ± 3.6 years), hypertension, diabetes, and heart failure were prevalent. Most participants had disabilities. The leading causes of death verified by autopsy were pulmonary edema, pneumonia, and ischemic myocardial disease. Although 48% scored a CDR greater or equal to 1, only 51% had a previous dementia diagnosis. Sedentary behavior, osteoarthritis, and depression were associated with higher odds of cognitive impairment, while married status, greater body mass index, hypertension, and neoplasia were related to lower odds.
Cognitive impairment and disability were common among Brazilians aged 90+. The BRAVO 90+ study will provide valuable insights into dementia and resilience in this population.
认知障碍和残疾在高龄人群中很常见，尤其是在低收入和中等收入国家（LMIC），这部分人群正在迅速增加。然而，在这些地区，针对90岁及以上人群的研究很少。在此，我们分析了巴西90岁以上老人研究（BRAVO 90+）的特征，该研究以巴西圣保罗市死亡的90岁及以上老年人为基于人群的样本。
描述巴西90岁及以上成年人的临床和功能特征，并调查与认知障碍相关的因素。
在死亡时收集数据。使用临床痴呆评定量表（CDR）对死亡前三个月的认知能力进行死后认知评估。我们调查了通过套索回归选择的与认知障碍相关的因素。
在409名参与者中（平均年龄 = 94 ± 3岁；72%为女性；69%为白人；平均受教育年限 = 3.3 ± 3.6年），高血压、糖尿病和心力衰竭很常见。大多数参与者有残疾。尸检证实的主要死因是肺水肿、肺炎和缺血性心肌病。尽管48%的参与者CDR评分大于或等于1，但只有51%的人之前被诊断为痴呆症。久坐行为、骨关节炎和抑郁症与认知障碍的较高几率相关，而婚姻状况、较高的体重指数、高血压和肿瘤则与较低几率相关。
认知障碍和残疾在90岁以上的巴西人中很常见。BRAVO 90+研究将为该人群的痴呆症和恢复力提供有价值的见解。
