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Dementia and all-cause mortality in older adults: Findings from the ELSI-Brazil study
Matheus Ghossain Barbosa1, Lucas Martins Teixeira1,2, Juliana Vaz de Melo Mambrini3
1Department of Psychiatry, Psychogeriatric Unit, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Introduction:
Although nearly two-thirds of all dementia cases occur in low- and middle-income countries, evidence on dementia-related mortality in these settings remains scarce.
Methods:
We analyzed 5249 participants aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Dementia was defined using an algorithm or self-reported diagnosis. Mortality rates were estimated by dementia status, sex, and age. Among individuals with dementia (n = 392), multivariate Cox models assessed predictors of all-cause mortality.
Results:
Mortality was higher in individuals with dementia even after adjusting for age and sex (hazard ratio: 2.65; 95% confidence interval: 2.08 to 3.39). Among people with dementia, male sex, higher education, poorer functional status, and lower cognitive performance increased mortality risk, while having a partner was protective.
Discussion:
Dementia markedly increased mortality risk. Functional impairment, cognitive decline, social support, and schooling were key determinants of survival, emphasizing the importance of targeted, context-specific strategies to improve outcomes for people living with dementia.
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