Association Between Consumption of Low- and No-Calorie Artificial Sweeteners and Cognitive Decline: An 8-Year Prospective Study.

Background And Objectives: Consumption of low- and no-calorie sweeteners (LNCSs) has been associated with adverse health outcomes. However, little is known about the association between consumption of LNCSs and cognition. The aim of this study was to investigate the association between consumption of LNCSs and cognitive decline.

Transcranial direct current stimulation plus cognitive training for cognitive symptoms in patients with post-acute sequelae of SARS-CoV-2 infection: A randomized, double-blind, sham-controlled trial.

Background: Post-acute sequelae of SARS-CoV-2 infection (PASC) is characterized by persistent cognitive deficits alongside anxiety and depression symptoms that adversely affect quality of life. Cognitive training (CT) programs and non-invasive neuromodulation, specifically transcranial direct current stimulation (tDCS), have each shown promise for alleviating similar deficits in non-clinical populations. However, their combined efficacy has not yet been evaluated in PASC patients.

The potential for dementia prevention in Brazil: a population attributable fraction calculation for 14 modifiable risk factors.

Background: The Lancet Commission on dementia prevention, intervention, and care 2024 updated the list of modifiable risk factors to include 14 factors. The potential for dementia prevention seems to be greater in low- and middle-income countries (LMIC) due to the higher prevalence of these factors. This study aims to provide the first LMIC figure for the potential for dementia prevention in Brazil attributed to 14 modifiable risk factors.

Population attributable fractions of modifiable dementia risk factors for cognitive impairment-the ELSA-Brasil cohort study.

Background: Population attributable fractions (PAF) of modifiable dementia risk factors are rarely estimated in low- and middle-income countries. We aim to estimate the relative risk (RR) for cognitive impairment and calculate the PAF in the (ELSA-Brasil).

Methods: We analyzed adults aged 35-74 at the baseline (2008-2010) and wave 3 (2017-2019).

Associations of neurodegenerative and cerebrovascular neuropathology with frailty in a diverse sample.

Associations between neurodegenerative and cerebrovascular neuropathologies and frailty are not well understood, especially in diverse populations. This study investigated these associations in an admixed Brazilian cohort. This cross-sectional study included participants aged 60 + from the Brazilian Biobank for Aging Studies (2004-2024).

Interventions for cognitive frailty: developing a Delphi consensus with multidisciplinary and multisectoral experts.

Introduction: The conjunction of physical frailty and cognitive impairment without dementia is described as Cognitive Frailty (CF). Indications that CF is potentially reversible have led to proposals that risk factors, symptoms or mechanisms of CF would be appropriate targets for interventions for prevention, delay or reversal. However, no study has brought experts together across sectors to determine targets, content or mode of interventions, and most resources on interventions are from the perspective of academic or clinical researchers only.

Selective Vulnerability of Hippocampi for Nitric Oxide Synthases in Alzheimer's Disease Pathology and Cognitive Abilities.

Alzheimer's disease (AD) neuropathological changes (ADNC) are characterized by amyloid plaques and neurofibrillary tangles. The role of nitric oxide synthase (NOS) in disease progression remains unclear. This study investigates the expression of neural, inducible, and endothelial NOS (nNOS, iNOS, eNOS) and 3-nitrotyrosine (3-NT) in the hippocampal subregions of individuals with ADNC and their association with cognitive abilities.

Rural-urban disparities in cognitive performance in Brazil and Mexico.

Objectives: There is little evidence of the disparities in cognitive performance in rural and urban areas in Latin America. We used data from the Brazilian Longitudinal Study of Aging (ELSI) and the Mexican Health and Aging Study (MHAS), to assess whether rurality is associated with cognitive impairment.

Methods: Cognitive impairment was determined using a regression-based approach.

Post-Discharge COVID-19 Symptoms Predict 1-Year Functional Decline, Falls, and Emergency Department Visits: A Cohort Study.

Background: Hospitalization frequently results in persistent symptoms among older adults, raising concerns about the long-term impacts of acute events-a problem amplified by COVID-19. We investigated the effects of persistent symptoms on functional decline and unplanned events over 1 year in older patients recovering from COVID-19 hospitalization.

Methods: This prospective cohort included patients aged ≥ 50 years who survived COVID-19 hospitalization between March and December 2020 as part of the CO-FRAIL study at Brazil's largest academic medical center.

Pulling Back the Curtain on Hospital Dementia Detection: Validation of the Informant-Based Clinical Dementia Rating.

Background: Dementia often goes undetected in hospital settings, where cognitive assessments are challenging due to illness severity and delirium. This study aimed to (1) evaluate the accuracy of the Clinical Dementia Rating (CDR), based solely on knowledgeable informant reports, for detecting preexisting dementia and cognitive impairment in hospitalized patients compared to a gold-standard diagnosis, (2) and compare its performance to the 16-item Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-16).

Methods: This cross-sectional study assessed consecutive patients aged ≥ 65 admitted to inpatient units from five hospitals in Brazil.

Sociodemographic and clinical profile from the Brazilian very old 90+ study (BRAVO-90+).

Background: Cognitive impairment and disability are frequent among the oldest-old population, particularly in low- and middle-income countries (LMIC), where this population is rapidly increasing. However, studies on people aged 90 or older are scarce in these settings. Here we analyze the characteristics of the Brazilian Very Old 90+ (BRAVO 90+) study, a population-based sample of 90+ older adults who died in Sao Paulo, Brazil.

Upregulation of NLRP3 Inflammasome in Specific Hippocampal Regions: Strengthening the Link Between Neuroinflammation and Selective Vulnerability in Alzheimer's Disease.

Neuroinflammation has emerged as an important mechanism in the early stages of neurodegenerative diseases. Experimental models have demonstrated the detrimental role of inflammasomes in the development of Alzheimer's disease (AD). However, neuropathological studies characterizing NLRP1 and NLRP3 pathways in AD are scarce.

Association of adiposity evaluated by anthropometric and bioelectrical impedance analysis measures with cognitive performance in the ELSA-Brasil study.

Background: While midlife obesity is linked to cognitive decline, this association is inconsistent in older adults, possibly due to the limitations of body mass index (BMI) in accurately assessing adiposity at older ages. Most studies focused on White or Asian populations, did not include other adiposity measures besides BMI, adjusted the analyses for mediators, and did not investigate potential subgroup-specific associations. We compared the associations of adiposity measured by anthropometrical and bioelectrical impedance analysis (BIA) with cognitive performance in a diverse population, examining modifications by age, sex, and race, and investigating the mediating effects of obesity-related comorbidities.

Association of Early- to Midlife Weight Trajectories With Mid- to Late-Life Cognitive Decline in the ELSA-Brasil Study.

Background And Objectives: While midlife obesity is consistently associated with cognitive decline in later life, there is limited understanding of how weight variations from early life to midlife affect cognitive decline. We investigated the association between early- to midlife weight trajectories and mid- to late-life cognitive decline.

Methods: This is a longitudinal cohort study that used data from 3 waves (2008-2019) of the Brazilian Longitudinal Study of Adult Health, a multicenter cohort study that enrolled active and retired public servants aged 35+ years from public universities in Brazil.

Association Between Alcohol Consumption, Cognitive Abilities, and Neuropathologic Changes: A Population-Based Autopsy Study.

Background And Objectives: Heavy alcohol consumption is a major global health concern linked to increased morbidity and mortality. However, the long-term impact of excessive alcohol consumption on cognitive abilities and dementia-related neuropathology is unclear. The aim of this study was to analyze the association between alcohol consumption and age-related neuropathologic outcomes in a population-based autopsy study.

Discordance between physical and cognitive health problems over one year after critical care: Insights from severe COVID-19 patients.

Objectives: To investigate the longitudinal evolution of physical and cognitive problems after hospital discharge in survivors of severe COVID-19; to describe the co-occurrence of these health problems domains in the following year after discharge; and evaluate if results are different taking into account the use of invasive mechanical ventilation.

Design: Prospective cohort study.

Setting: A large academic medical center in Brazil.

Pathways underlying selective neuronal vulnerability in Alzheimer's disease: Contrasting the vulnerable locus coeruleus to the resilient substantia nigra.

Introduction: Alzheimer's disease (AD) selectively affects certain brain regions, yet the mechanisms of selective vulnerability remain poorly understood. The neuromodulatory subcortical system, which includes nuclei exhibiting a range of vulnerability and resilience to AD-type degeneration, presents a framework for uncovering these mechanisms.

Methods: We leveraged transcriptomics and immunohistochemistry in paired samples from human post mortem tissue representing a vulnerable and resilient region-the locus coeruleus (LC) and substantia nigra (SN).

Intrinsic capacity and loneliness, according to sex, in an upper-middle income country: insights from the ELSI-Brazil cohort.

Objectives: To investigate the association between loneliness and intrinsic capacity, a multidimensional indicator of healthy ageing, in Brazilians aged ≥50 years.

Method: This cross-sectional study used baseline data from 7,123 participants of the nationally representative Brazilian Longitudinal Study of Aging (ELSI-Brazil) (2015-2016). Intrinsic capacity (IC) (sensory, mobility, psychological, cognitive, and vitality), was determined using a validated composite z-score (higher scores = better capacity).

Non-linear associations of serum lipid levels with cognitive decline: Findings from the ELSA-Brasil cohort.

Background And Aims: Elevated low-density lipoprotein-cholesterol (LDL-C) is a modifiable risk factor for dementia, but evidence on other lipids is inconsistent, particularly in studies from low and middle-income countries. This study aimed to assess the association between lipid levels and cognitive decline in the ELSA-Brasil cohort.

Methods: In this prospective study, baseline serum lipid profile [total cholesterol (TC), LDL-C, high-density lipoprotein-cholesterol (HDL-C), triglycerides, and non-high-density lipoprotein-cholesterol (Non-HDL-C)] was analyzed.

Hand Grip Strength Cut-Off Points as a Discriminator of Sarcopenia and Sarcopenic Obesity: Results from the ELSA-Brasil Cohort.

Background: Hand grip strength (HGS) may represent an epidemiologically relevant alternative as an initial screening tool for sarcopenia and sarcopenic obesity. However, no study evaluated the performance capacity of HGS compared to other biomarkers in discriminating these conditions in adults.

Objective: The study aimed to evaluate the performance of HGS as discriminator of sarcopenia and sarcopenic obesity, compared to urinary biomarkers of creatinine and potassium in 24 h for Brazilian adults.

Mapping the Numbers of Dementia in Brazil: A Delphi Consensus Study.

Objectives: As the global dementia crisis intensifies, especially in low-and middle-income countries (LMICs), there is a pressing need for comprehensive prevalence data across diverse regions, including Brazil, where studies have been predominantly limited to affluent urban centers. This study aimed to conduct an expert consensus to determine the prevalence of all-cause dementia in Brazil, considering various age groups, sexes, and geographical areas.

Methods: A Delphi consensus process with clinical and academic experts from across Brazil was conducted to provide dementia prevalence estimates in people aged ≥ 60 years living throughout Brazil for 2019.

Hearing loss and cognitive decline in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) during eight years of follow-up.

BackgroundHearing loss (HL) of moderate or higher grades is common in older adults with increasing prevalence as people age, rising from 12% at the age of 60 years to over 58% at 90 years. HL in midlife is one of the main potentially modifiable risk factors for dementia. It is estimated that 7% of dementia cases globally could be avoided if this risk factor was eliminated.

Social and health disparities associated with healthy brain ageing in Brazil and in other Latin American countries.

Background: Latin American countries present major health-related inequities due to historical, cultural, and social aspects. Recent evidence highlights that factors related to social and health disparities outweigh classic demographic factors in determining healthy brain aging in these populations. However, these analyses have not been conducted with the Brazilian population, the largest and most ethnically diverse population in Latin America.

External Validation of the Walter Index for Posthospitalization Mortality Prediction in Older Adults.

Importance: The Walter Index is a widely used prognostic tool for assessing 12-month mortality risk among hospitalized older adults. Developed in the US in 2001, its accuracy in contemporary non-US contexts is unclear.

Objective: To evaluate the external validity of the Walter Index in predicting posthospitalization mortality risk in Brazilian older adult inpatients.