Understanding Healthy Aging and Disparities: New Insights from a Latin American Study

A new healthy aging study led by researchers from BrainLat, GBHI and other institutions presents groundbreaking findings with significant global and regional implications.

A landmark study conducted by a multinational research team led by scientists from the Latin American Brain Health Institute (BrainLat) at Universidad Adolfo Ibanez, the Global Brain Health Institute (GBHI) at the University of California San Francisco (UCSF) and Trinity College Dublin, and the Universidad Javeriana in Colombia among other institutions, reveals crucial insights into the factors that influence healthy aging in Latin American countries (LACs).

The research, involving a study group of 44,394 participants from different Latin American countries, utilized machine learning models to explore the complex interplay of factors contributing to healthy aging, focusing on social determinants of health (SDH), lifestyle factors, health status (cardiometabolic factors), mental health symptoms, and demographics (age, sex).

Healthy Aging in Latin America

Latin America is characterized by sociodemographic, ethnic, and cultural diversity, presenting unique challenges to the current universal models of healthy aging. "The research reveals that unlike in high-income regions where age and sex predominantly drive healthy aging, in Latin American countries, disparity-related factors such as SDH, mental health symptoms, and cardiometabolic risks have a significant influence. The effects were even more pronounced in low-middle-income countries compared to high-income ones within the region," said Agustin Ibanez, one of the study's lead authors. The combination of factors yielded a more substantial effect with heterogenous arrangements across the region. More important, the classical effects of age or gender were less relevant than disparity-related health and social factors.

The current research provides crucial insights into the multi-faceted determinants of healthy aging in LACs and paves the way for regionally tailored public health interventions. Furthermore, it fills significant knowledge gaps, providing a better understanding of the unique determinants and risk factors of aging in the region, the interactions between these risk factors, and the use of machine learning procedures for assessment.

"Social and health disparity-related factors play a more significant role in healthy aging than demographic factors such as age and sex in Latin American countries," said Hernando Santamaria Garcia, first author. "These findings have crucial implications for public health policy, highlighting the need for interventions addressing these unique regional risks," he added.

Addressing Unique Risk Factors

With an estimated dementia prevalence of 8.5%, projected to increase to 19.33% by 2050 in Latin American populations, the study underlines the urgent need to address these unique risk factors to foster healthier societies. By leveraging machine learning methods, the study effectively navigated the complex interactions between risk factors and outcomes, helping identify top predictors without assuming a priori theoretical rankings.

"Our study invites public health leaders to prioritize programs addressing multimodal disparities and promoting mental health across the lifespan," said Victor Valcour, co-author. For Brian Lawlor, co-author, "there is an urgent need to address health inequities and to develop strategies that enhance social networks, stimulate physical activity, and provide public resources to encourage healthier lifestyles and reduce the risks associated with non-communicable diseases, highly prevalent in the region."

The research reinforces the need for tailored, multi-faceted public health strategies in LACs, addressing the region-specific risk factors that influence healthy aging. By providing a robust foundation for informing policy, the study optimizes resource allocation in public health and fosters healthier societies. For Carolina Ochoa, co-author, "the potential combination of risk factors that influence aging across populations in Latin American countries (LACs) remains unknown". "Compared to HICs, in LACs converging multiple factors were associated with less healthy aging, including a significant contribution of SDH; a higher prevalence of cardiometabolic factors, mental health symptoms; and barriers to a healthy lifestyle," said Jaime Miranda, co-author. For Michael Corley, Assistant Professor at Weill Cornell Medicine and co-author, "Our results also invite us to develop social and health plans to handle various aging risks simultaneously rather than reacting to one factor at a time." The study presents robust methodological approaches involving "a systematic curation, harmonization and standardization of multiple datasets" (Agustin Sainz-Ballesteros, co-author), "robust machine learning and predictive models" (Sebastian Moguilner, co-author), "control for multicollinearity, high-dimensional data, and stability of the models" (Hernan Hernandez, co-author) and "incorporate sample validation processes, thereby providing a more reliable assessment of the model's performance" (Marcelo Maito, co-author).

Publication: Santamaria-Garcia NS-B, A; Hernandez, H; Moguilner, S; Maito, M; Ochoa-Rosales, C; Corley, M; Valcour, V; Miranda, J; Lawlor, B; Ibanez, A. Factors associated with healthy aging in Latin American populations. Nature Medicine, 2023, https://doi.org/10.1038/s41591-023-02495-1