| Summary |
In Latin America, healthy aging patterns present unique challenges. The sociodemographic, ethnic and cultural diversity of the region challenges universal models of healthy aging. In a study published in Nature Medicine , we investigated the combined impact of social determinants of health (SDH), lifestyle, cardiometabolic health, mental health, and demographics on healthy aging in 44,394 participants from Latin American countries. The results showed a distributed and heterogeneous set of predictors related to social and health inequity that influence cognition (mental health symptoms, SDH, education, physical activity) and functional capacity (mental health symptoms, SDH, education , physical activity, and cardiometabolic factors) in different Latin American countries. The results show that the combination of these factors is critical and does not follow the patterns observed in other regions. These predictor differences were more pronounced in low- and middle-income Latin American countries compared to high-income ones. Across all analyses, predictors related to social and health disparity were more strongly associated with healthy aging than classic factors such as age and sex. These factors associated with disparities also presented many variations between countries. The findings offer a comprehensive picture of the multi-level determinants of healthy aging in Latin America, underscoring the crucial need for region-specific interventions that can effectively address healthy aging. |
| Latin America: land of contrasts and challenges for brain health |
“Poverty is not an accident. Like slavery and apartheid, it is a creation of man and can be eliminated by the actions of human beings” (Nelson Mandela)
“America is, for the world, nothing more than the United States: we inhabit, at most, a sub-America, a second-class America, of nebulous identification. It is Latin America, the region of open veins” (Eduardo Galeano)
Aging is not a globally uniform process. Existing models of brain health are based on studies developed mostly in the global north, such as the United States and Europe. However, the risk factors in Latin America are unique and have not yet been studied in sufficient detail.
The prevalence of dementia, which is expected to increase by 220% by 2050 in the region, demands special attention. This is how addressing the lack of knowledge about specific risk factors in Latin America represents a critical priority for understanding healthy aging, especially given the socioeconomic and health disparities in this region.
| Our studio |
Using advanced machine learning techniques, this study analyzed a wide range of risk factors that affect cognition and functional ability in healthy aging. We assessed multiple potential risk factors (demographic characteristics, SDH, cardiometabolic health, mental health, and lifestyle) that affect cognition and functional capacity in healthy aging (total n=44,394 participants, Figure 1). Cross-sectional and longitudinal data from nationally representative survey cohorts included several countries with different levels of socioeconomic development. As a first step, a multi-method approach (Figure 1) comprising linear regression, elastic net, lasso , and ridge regression was implemented to ensure the robustness of our machine learning results.
Figure 1. Healthy aging in Latin America. This figure shows the factors we use to determine healthy aging and the associated risk factors. In addition, the results of the specific risk factors that determined cognitive health and functional health in four Latin American countries are shown, including Chile, Uruguay, Ecuador and Colombia.
| The results |
Analyzes revealed that social determinants of health (SDH), physical activity, mental health conditions and cardiometabolic factors exhibit a significant association with cognition and functional capacity, but with nuanced variations between different countries regarding healthy aging. . Surprisingly, these factors had a greater effect than traditional factors such as age and sex, particularly in low-income countries.
Healthy aging depends on a heterogeneous combination of risk factors that are not universally applicable to various contexts. Notably, factors related to social and health disparities (e.g., education, cardiometabolic conditions, social isolation, mental health), which influenced cognition and functional ability in aging, had a greater effect than those of the factors classics (age and sex) and deviated from patterns observed in other regions in terms of the main risk factors and interactions between risks related to disparities.
These findings offer a more detailed picture of the multilevel determinants of healthy aging in Latin America, highlighting the crucial need to develop public prevention policies and region-specific interventions tailored to effectively address healthy aging.
| What can we do with this knowledge? |
These findings have multiple implications for public health policies in Latin America. By understanding the crucial role that various factors play (such as socioeconomic disparities, physical activity and mental health), governments can tailor interventions according to their particularities in each country. This could include improving socioeconomic structures, promoting healthy lifestyles, and increasing national plans to manage chronic health conditions.
The study also reinforces the need for multifaceted approaches adapted to Latin American countries, targeting specific risk factors that influence healthy aging. Our results suggest the need to develop health and social plans that address the combination of multiple aging risk factors simultaneously. In simple and direct words, we must take charge of the multidimensional impact of poverty and inequality if we want to guarantee healthy aging in our Latin American nations.
Furthermore, it is important to remember that aging is a continuous process, where risk and protective factors exert a cumulative influence throughout a person’s entire life. For this reason, it is essential that strategies to address these factors consider the individual throughout the life cycle and not only during advanced age.
| Conclusions |
Healthy aging in Latin America results from the complex and multifaceted interaction of social and health inequality factors. This study represents an important step towards a deeper understanding of the determinants of healthy aging in the region, and offers a basis for the development of effective and personalized public health policies and interventions. By focusing on the unique aspects of aging in Latin America, the research advocates for a more situated and inclusive approach, essential for the well-being of millions of people in the region.
