Observational studyPloS one2026
A decade of difference: cross-continental patterns of functional performance in Brazil and Europe within the WHO ICOPE framework.
Observational study in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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8 authors.
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Abstract
introductionGlobal aging patterns are highly heterogeneous, especially in diverse socioeconomic contexts.
objectiveWe aimed to analyze the determinants of functional performance within the WHO's Integrated Care for Older People (ICOPE) framework.
methodsFunctional performance was evaluated using basic and instrumental activities of daily living (BADL/IADL) from ELSI-Brasil and SHARE cohorts. Sociodemographic characteristics and the clinical domains of intrinsic capacity (mobility, vitality, cognition, psychological, and sensory functions) were also assessed.
resultsThe final sample consisted of 4,825 participants from ELSI-Brasil and 25,978 from SHARE. Functional risks diverged significantly based on intrinsic capacity domains: i) mobility: handgrip strength was a stronger protective factor in Europe, while the walking speed was a unique BADL risk factor in Brazil (OR 1.16); ii) vitality: weight loss showed a significant BADL risk for Europeans (OR 1.18); iii) cognition: low self-perceived memory showed similar risk for IADL across both cohorts (SHARE OR 1.23 vs. ELSI-Brasil OR 1.22); iv) psychological: depression posed a higher independent risk in Europe (OR 1.67-1.71) than in Brazil (OR 1.26-1.53), while poor self-rated health reflected higher risk in the Brazilian context (BADL OR 2.72 vs. 2.07 in Europe); v) sensory function: hearing impairment was a stronger IADL risk in Brazil (OR 1.27), while vision was significant only in Europe (OR 1.32).
conclusionsFunctional decline begins a decade earlier in Brazil than in Europe, reflecting socioeconomic disparities across intrinsic capacity domains. ICOPE strategies should be tailored to each societal context to promote equitable healthy aging.
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