Cognitive function among older adults: ELSI-Brazil results

Castro-Costa, Erico; Lima-Costa, Maria Fernanda; Andrade, Fabíola Bof de; Souza Junior, Paulo Roberto Borges de; Ferri, Cleusa Pinheiro

doi:10.11606/S1518-8787.2018052000629

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Brasil

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Sumário

Supplement ELSI-Brazil, Original Article • Rev. Saúde Pública 52 (Suppl 2) • 2018 • https://doi.org/10.11606/S1518-8787.2018052000629 copy

Cognitive function among older adults: ELSI-Brazil results

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To investigate macroregional variations in cognitive function in a national sample representative of the Brazilian population aged 50 years and older.

METHODS

Data from the baseline of the Longitudinal Study of Brazilian Elderly (ELSI-Brazil), collected between 2015 and 2016, were used. Memory was measured by means of a 10-word list and executive function, by semantic verbal fluency, based on the naming of animals. Gender, age, education, and rural or urban residence were potentially confounding

RESULTS

Among the 9,412 ELSI-Brazil participants, 9,085 were included in the analysis; 53.9% were women and the average age was 63.0 (0.42) years. After adjusting for potential confounding variables, average scores for memory and verbal fluency were lower in the Northeast region and higher in the Midwest and Southeast, respectively. In the South region, higher scores were found for immediate and combined memory. In all regions, older participants and those with lower schooling had worse scores for memory and verbal fluency.

CONCLUSIONS

There are differences in cognitive function among older adults in the different macroregions, independent of age, gender, schooling, and rural or urban residence.

Aged; Cognition; Memory; Socioeconomic factors

Characteristic	Total	North	Northeast	Southeast	South	Midwest	p

	n = 9,085	n = 713	n = 2,416	n = 3,825	n = 1,234	n = 897
Gender: female (%)	53.9	49.9	54.6	54.5	53.6	52.1	0.934
Age – average (SE)	63.0 (0.42)	62.1 (0.67)	63.3 (0.75)	63.0 (0.72)	63.0 (0.92)	62.3 (1.1)	0.945
Education (years) (%)							< 0.0001
> 11	23.8	26.3	18.3	26.3	24.2	23.7
8–10	11.9	15.6	8.9	12.9	12.2	11.3
4–7	31.4	25.4	23.2	34.4	36.9	31.8
< 4	32.8	32.7	49.5	26.4	26.7	33.2
Place of residence: Rural (%)	15.3	17.7	30.3	6.5	21.6	5.6	0.006
Memory - mean (SE)
Immediate	4.3 (0.05)	4.2 (0.11)	3.8 (0.08)	4.5 (0.06)	4.6 (0.07)	4.3 (0.07)	< 0.0001
Late	2.9 (0.06)	2.7 (0.15)	2.4 (0.09)	3.0 (0.07)	3.0 (0.09)	3.1 (0.13)	< 0.0001
Combined	7.3 (0.10)	7.0 (0.24)	6.2 (0.17)	7.5 (0.13)	7.7 (0.16)	7.6 (0.19)	< 0.0001
Verbal fluency - mean (SE)	12.6 (0.29)	11.4 (0.37)	11.4 (0.85)	13.2 (0.41)	12.6 (0.40)	12.9 (0.38)	0.012

Cognitive function	North		Northeast		Southeast		South		Midwest

	Average	95%CI	Average	95%CI	Average	95%CI	Average	95%CI	Average	95%CI
Memory
Immediate	4.22	3.99–4.45	3.83	3.65–4.00	4.51	4.40–4.63	4.60	4.45–4.75	4.43	4.30–4.56
Late	2.76	2.45–3.07	2.42	2.23–2.60	3.05	2.90–3.20	3.09	2.92–3.27	3.15	2.89–3.41
Combined	6.99	6.53–7.46	6.26	5.92–6.60	7.58	7.32–7.83	7.70	7.39–8.01	7.60	7.22–7.99
Verbal fluency	11.52	10.78–12.27	11.41	9.73–13.09	13.24	12.42–14.06	12.64	11.84–13.44	13.01	12.25–13.77

	β	95%CI	β	95%CI	β	95%CI	β	95%CI	β	95%CI

Immediate Memory
Gender (F versus M)	0.22	-0.15–0.59	0.01	-0.10–0.13	0.07	-0.07–0.21	0.04	-0.17–0.27	0.03	-0.13–0.19
Age (≥ 75 versus < 75)	-1.95	-2.33– -1.57	-1.31	-1.45– -1.18	-1.20	-1.36– -1.03	-1.55	-1.90– -1.19	-1.49	-1.16– -1.36
Education (< 11 versus ≥ 11)	-0.96	-1.28– -0.64	-1.17	-1.36– -0.97	-1.02	-1.13– -0.91	-1.01	-1.19– -0.82	-1.07	-1.49– -0.66
Place of residence (rural versus urban)	-0.06	-0.30–0.16	-0.26	-0.39– -0.13	-0.51	-0.66– -0.36	-0.04	-0.32–0.24	0.01	-0.07–0.09
Late Memory
Gender (F versus M)	0.09	-0.17–0.35	0.07	-0.07–0.21	0.07	-0.08–0.23	0.26	0.06–0.46	0.00	-0.44–0.44
Age (≥ 75 versus < 75)	-1.76	-2.23– -1.30	-1.13	-1.30– -0.96	-1.52	-1.70– -1.33	-1.54	-1.76– -1.32	-1.45	-1.70– -1.20
Education (< 11 versus ≥ 11)	-1.02	-1.27– -0.76	-1.22	-1.41– -1.03	-1.21	-1.35– -1.06	-1.11	-1.32– -0.89	-1.12	-1.57– -0.67
Place of residence (rural versus urban)	0.13	-0.25–0.53	-0.24	-0.53–0.05	-0.54	-0.77– -0.30	-0.22	-0.45–0.02	0.39	0.25–0.52
Combined Memory
Gender (F versus M)	0.31	-0.28–0.90	0.08	-0.14–0.31	0.14	-0.12–0.42	0.31	-0.11–0.73	0.03	-0.55–0.61
Age (≥ 75 versus < 7 5)	-3.72	-4.52– -2.92	-2.44	-2.70– -2.19	-2.72	-3.04– -2.40	-3.09	-3.66– -2.53	-2.94	-3.25– -2.62
Education (< 11 versus ≥ 11)	-1.99	-2.51– -1.46	-2.39	-2.73– -2.05	-2.23	-2.47– -1.99	-2.12	-2.46– -1.78	-2.20	-3.06– -1.34
Place of residence (rural versus urban)	0.06	-0.50–0.63	-0.50	-0.86– -0.15	-1.05	-1.34– -0.76	-0.26	-0.74–0.22	0.40	0.22–0.58
Verbal Fluency
Gender (F versus M)	-1.24	-2.04– -0.44	0.02	-2.07–2.13	-1.44	-3.34–0.45	-0.46	-0.96–0.03	-0.99	-1.72– -0.27
Age (≥ 75 versus < 75)	-1.84	-2.66– -1.03	-2.33	-4.35– -0.31	3.74	-2.23–9.72	-2.04	-2.71– -1.38	-2.09	-2.76– -1.42
Education (< 11 versus ≥ 11)	-1.57	-2.44– -0.70	-1.75	-4.04–0.52	-2.71	-3.53– -1.88	-3.60	-4.24– -2.97	-2.45	-4.15– -0.75
Place of residence (rural versus urban)	-0.20	-1.18–0.77	-1.07	-3.53–1.39	0.90	-3.97–5.78	-0.73	-1.46– -0.01	-1.10	-1.84– -0.36

Cognitive function	Standardized by gender		Standardized by age		Standardized by schooling		Standardized by place of residence		Standardized by the 4 variables

	Average Score	95%CI	Average Score	95%CI	Average Score	95%CI	Average Score	95%CI	Average Score	95%CI
Immediate memory
North	4.24	4.00–4.47	4.03	3.85–4.20	4.11	3.91–4.31	4.23	4.03–4.43	4.08	3.92–4.24
Northeast	3.83	3.65–4.00	3.74	3.60–3.88	3.97	3.87–4.07	3.89	3.71–4.08	3.82	3.72–3.93
Southeast	4.51	4.40–4.63	4.44	4.34–4.55	4.37	4.30–4.44	4.45	4.36–4.54	4.38	4.31–4.45
South	4.60	4.45–4.74	4.50	4.32–4.68	4.46	4.35–4.57	4.62	4.50–4.74	4.50	4.38–4.61
Midwest	4.43	4.29–4.57	4.29	4.18–4.40	4.37	4.33–4.42	4.41	4.29–4.54	4.33	4.25–4.40
Late Memory
North	2.76	2.45–3.07	2.56	2.24–2.87	2.65	2.26–3.05	2.76	2.44–3.09	2.62	2.25–2.99
Northeast	2.42	2.24–2.61	2.34	2.20–2.48	2.54	2.41–2.68	2.48	2.31–2.66	2.42	2.32–2.52
Southeast	3.05	2.91–3.20	2.97	2.86–3.08	2.89	2.80–2.99	2.98	2.86–3.11	2.90	2.81–2.99
South	3.10	2.92–3.28	2.99	2.81–3.17	2.96	2.81–3.11	3.12	2.98–3.27	3.01	2.86–3.16
Midwest	3.15	2.90–3.42	2.99	2.81–3.18	3.10	2.98–3.22	3.18	2.94–3.41	3.09	2.96–3.22
Combined Memory
North	7.01	6.55–7.48	6.60	6.17–7.03	6.78	6.18–7.37	7.01	6.52–7.49	6.72	6.21–7.22
Northeast	6.26	5.92–6.61	6.09	5.83–6.35	6.52	6.30–6.74	6.38	6.04–6.73	6.25	6.06–6.43
Southeast	7.58	7.33–7.83	7.42	7.22–7.62	7.28	7.13–7.43	7.44	7.24–7.65	7.29	7.14–7.44
South	7.70	7.39–8.01	7.50	7.16–7.84	7.43	7.18–7.67	7.75	7.50–7.99	7.52	7.27–7.76
Midwest	7.60	7.22–7.99	7.29	7.02–7.57	7.49	7.35–7.62	7.62	7.28–7.96	7.46	7.28–7.64
Verbal fluency
North	11.44	10.66–12.23	11.23	10.73–11.73	11.30	10.98–11.71	11.53	10.83–12.24	11.30	10.70–11.89
Northeast	11.41	9.69–13.13	11.23	9.79–12.66	11.79	9.88–13.71	11.60	9.66–13.54	11.54	9.53–13.55
Southeast	13.21	12.41–14.01	13.33	12.34–14.32	13.26	12.10–14.41	13.26	12.31–14.21	13.41	11.94–14.89
South	12.62	11.83–13.40	12.48	11.69–13.26	12.39	11.85–12.92	12.74	12.23–13.26	12.41	11.91–12.91
Midwest	12.97	12.22–13.71	12.75	12.07–13.44	12.86	12.32–13.40	12.87	12.14–13.60	12.77	12.11–13.44

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[1] Correspondence: Erico Castro-Costa. Av. Augusto de Lima, 1715 30190-002 Belo Horizonte, MG, Brasil E-mail: ericocastrocosta@gmail.com