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Lima-Silva ML, Torres KCL, Mambrini JVDM, Brot NC, Santos SO, Martins-Filho OA, Teixeira-Carvalho A, Lima-Costa MF, Peixoto SV. A nationwide study on immunosenescence biomarkers profile in older adults: ELSI-Brazil. Exp Gerontol 2024; 191:112433. [PMID: 38621429 DOI: 10.1016/j.exger.2024.112433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/19/2024] [Accepted: 04/12/2024] [Indexed: 04/17/2024]
Abstract
Immunosenescence is a phenomenon caused by changes in the immune system, and part of these changes involves an increase in circulating immunological biomarkers, a process known as "Inflammaging." Inflammaging can be associated with many diseases related to older people. As the older population continues to grow, understanding changes in the immune system becomes essential. While prior studies assessing these alterations have been conducted in countries with Caucasian populations, this investigation marks a pioneering effort. The object of the study is to describe for the first time that the distribution of cytokines, chemokines, and growth factors serum levels, assessed by Luminex platform, has been examined in a Brazilian population-based study of older adult females and males by age. Blood samples from 2111 participants (≥50 years old) were analyzed at the baseline (2015/2016) of the ELSI-Brazil study. The exploratory variables considered in the study were age, sex, educational level, residence area, geographic region, alcohol and smoking consumption, physical activity, and self-reported medical diagnoses of hypertension, diabetes, asthma, arthritis, and cancer. The association between serum biomarker levels and age was assessed by a quantile regression model adjusted in the total population and stratified by sex. The significance level considered in the analysis was 0.05. The mean age of the participants was 62.9 years, with a slight majority of female (52.7 %). Differences were found between the sexes in the median circulating levels of the CCL11, CXCL10, and FGF biomarkers. Eight biomarkers showed significant associations with age, including the pro-inflammatory CXCL10, TNF-α, IL-6, IL-17, and IL-2; and type 2/regulatory CCL11 and IL-4, showing positive associations, and anti-inflammatory IL-1Ra showing a negative association. The results suggest similar associations between the sexes, revealing an inflammatory profile characterized by types 1 and 2. Remarkably, these findings reinforce the concept of the Inflammaging process in Brazilian population. These findings add novel insights to about the immunosenescence aspects in middle-income countries and help define biomarkers capable of monitoring inflammation in older adults.
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Affiliation(s)
- Maria Luiza Lima-Silva
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Programa de Pós-Graduação em Saúde Coletiva, Belo Horizonte, MG, Brazil.
| | - Karen Cecília Lima Torres
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade Edson Antônio Velano - UNIFENAS/MG, Brazil.
| | - Juliana Vaz de Melo Mambrini
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Programa de Pós-Graduação em Saúde Coletiva, Belo Horizonte, MG, Brazil
| | - Nathalia Coimbra Brot
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil
| | - Sara Oliveira Santos
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil
| | - Olindo Assis Martins-Filho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade do Estado do Amazonas - UEA, Brazil
| | - Andréa Teixeira-Carvalho
- Fundação Oswaldo Cruz, Instituto René Rachou, Grupo Integrado de Pesquisas em Biomarcadores, Belo Horizonte, MG, Brazil; Universidade do Estado do Amazonas - UEA, Brazil
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil
| | - Sérgio Viana Peixoto
- Fundação Oswaldo Cruz, Instituto René Rachou, Núcleo de Estudos em Saúde Pública e Envelhecimento, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais, Escola de Enfermagem, Departamento de Gestão em Saúde, Belo Horizonte, MG, Brazil.
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Mrejen M, Nunes L, Giacomin K. Socioeconomic inequalities in health and healthcare utilization among the elderly in Brazil: results from the 2019 National Health Survey. Public Health 2024; 226:165-172. [PMID: 38071949 DOI: 10.1016/j.puhe.2023.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/26/2023] [Accepted: 11/08/2023] [Indexed: 01/15/2024]
Abstract
OBJECTIVES To assess socioeconomic-related inequalities in health and healthcare utilization among the elderly in Brazil. STUDY DESIGN Cross-sectional nationally representative household-based survey. METHODS We evaluated the Brazilian National Health Survey data collected in 2019. We computed the prevalence of measures of health conditions and healthcare utilization by age-bracket and markers of socioeconomic status-income, educational attainment, and race/ethnicity-among individuals aged 60 or older. We further employed logistic regression models, adjusted for a wide set of covariates, to estimate the relationship between socioeconomic status and those outcomes. RESULTS Higher-income and more educated individuals exhibit better health conditions compared to their lower-income and less-educated counterparts within each age bracket. Results from regression models showed strong associations with income and educational attainment for most health conditions: health status, physical activity, difficulties with activities of daily living and instrumental activities of daily living, and depression. For most conditions, weaker or no associations with race/ethnicity were found. Individuals in the highest income quintile and that completed higher education also had higher odds of having consulted a physician, while high-income individuals had lower odds of having received emergency care at home. CONCLUSIONS The findings of this study highlight the significant socioeconomic inequalities in the health of the elderly population in Brazil. The substantial and pervasive nature of these inequalities stresses the need for action to address them.
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Affiliation(s)
- M Mrejen
- Instituto de Estudos para Políticas de Saúde (IEPS), São Paulo, SP, Brazil.
| | - L Nunes
- Insper, São Paulo, SP, Brazil
| | - K Giacomin
- NESPE, FIOCRUZ/UFMG, Belo Horizonte, MG, Brazil
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