Differences in disability and nutritional status among older Brazilian and English adults: the Brazilian Longitudinal Study of Aging (ELSI-Brazil) and English Longitudinal Study of Aging (ELSA) cohorts.
BACKGROUND
Brazil and England are 2 countries at different stages in their demographic, epidemiological, and nutritional transitions and with distinct socioeconomic and politic contexts, but with similar universal health systems. We aimed to examine disability and its association with objective anthropometric indicators of nutritional status, including BMI, waist circumference, and waist-to-height ratio, comparing older Brazilian and English adults.


METHODS
We used cross-sectional data from 2 nationally representative aging studies. For Brazil, we included 9412 participants who participated in the baseline (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The English data were from 8024 participants of the wave 6 (2012-2013) of the English Longitudinal Study of Aging (ELSA). Disability was defined as difficulty to perform at least 1 activity of daily living. We used logistic regression models to examine the association between anthropometric indicators and disability, adjusted for sociodemographic and health-related characteristics, considering the interaction term between each anthropometric indicator and country.


RESULTS
All health-related characteristics were worse in Brazil than England, although the prevalence of disability was similar among Brazilian (17.85%) and English (16.27%) older adults. Fully adjusted models showed statistically significant interaction terms between country and anthropometric indicators. The strength of the associations in Brazil was weaker compared with England. All anthropometric indicators were positively associated with disability: elevated BMI, in Brazil (OR: 1.27; 95% CI: 1.06, 1.51) and in England (OR: 1.80; 95% CI: 1.51, 2.14); elevated waist circumference, in Brazil (OR: 1.21; 95% CI: 1.02, 1.44) and in England (OR: 1.90; 95% CI: 1.51, 2.37); and elevated waist-to-height ratio, in Brazil (OR: 1.20; 95% CI: 0.96, 1.52) and in England (OR: 1.83; 95% CI: 1.37, 2.44).


CONCLUSIONS
Elevated BMI and waist circumference increased the odds of disability in both populations. However, these associations were stronger in England than in Brazil.
['Tavares Milhem Ygnatios|Nair|N|0000-0002-8862-1930', 'de Oliveira|Cesar|C|', 'Vaz de Melo Mambrini|Juliana|J|0000-0002-3687-897X', 'Bof de Andrade|Fabíola|F|', 'Lima-Costa|Maria Fernanda|MF|', 'Lustosa Torres|Juliana|J|']
D000368:Aged D000375:Aging D015992:Body Mass Index D001938:Brazil D015331:Cohort Studies D003430:Cross-Sectional Studies D006233:Disabled Persons D004739:England D006801:Humans D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D009752:Nutritional Status D055105:Waist Circumference D065927:Waist-Height Ratio
aging waist circumference activities of daily living anthropometry body mass index