Public Health

Area of Science:

• Gerontology
• Public Health
• Health Disparities

Background:

• Societies shaped by slavery and segregation exhibit healthcare access disparities, especially for older adults.
• Black older adults face higher risks of cognitive impairment and underdiagnosis compared to White individuals.
• Limited research exists on racism's health impact, particularly intersectionality in older adults.

Purpose of the Study:

• Investigate the association between strength levels and cognitive impairment in older adults.
• Examine how racial, gender, and income inequalities influence this association.
• Compare these dynamics in Brazil and the United States.

Main Methods:

• Cross-sectional study using data from ELSI-Brazil and Health and Retirement Study (USA).
• Assessed strength via handgrip and cognitive status using the Verbal Fluency test (VF).
• Employed comparative tests, logistic regression, and machine learning to analyze mediating factors (race, income, gender, health).

Main Results:

• Older Black adults in both countries had worse VF scores than Whites.
• Brazilian Black adults had nearly three times the risk of cognitive impairment compared to White Americans.
• Being a Black woman with low socioeconomic status and multiple chronic diseases indicated over 52% probability of cognitive impairment in Brazil.

Conclusions:

• Handgrip strength is more strongly linked to cognitive levels in Brazilian older adults.
• Brazilian Black women exhibit a higher risk of cognitive impairment on the VF test than their US counterparts.
• Findings underscore the need for targeted interventions addressing health inequalities in aging populations.