Sociodemographic and clinical profile from the Brazilian very old 90+ study (BRAVO-90+).

Abstract

Background: 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.

Objective: To describe clinical and functional characteristics and investigate factors associated with cognitive impairment in Brazilian adults 90 years or older.

Methods: 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.

Results: 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.

Conclusions: 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.