Brazil is getting older: some lessons from the Bambuí Health and Aging Study.

Sao Paulo Med J 2004; 122(3):79-80. The difference in Brazil’s age structure between 1980 and 2000 is very impressive, as shown in Figure 1. To demonstrate the process of aging that has taken place in this country, the proportion of the population aged over 60 years has increased from 6.1% to 8.6%. In 1980, no Brazilian State had more than 10% of its population in this age stratum. In 2000, the States of Rio de Janeiro (10.7%) and Rio Grande do Sul (10.5%) reached this level. The cities of Rio de Janeiro (12.7%) and Porto Alegre (11.8%) are the state capitals with the greatest numbers of elderly people. The proportion of the Brazilian population aged over 80 years in 2000 (1.1%) was twice what it was in 1980 (0.5%). Contrary to common sense, the population aging process is due to the decline in fertility rather than lower mortality rates. To back up this statement, a comparison between the demographic dynamics of the United Kingdom (UK) and Brazil is very interesting. The total fertility rate (TFR) started to decline in the UK from 1870 onwards, from 5.3 births/woman aged 15-49 years, to reach a TFR of 2.2 by 1970. This was a decrease of 58% over one century. In Brazil, the TFR was 5.8 in 1970 (not 1870 as in the UK), and this had declined to 2.3 by 2000, i.e. a 60% reduction over only 30 years. Obviously, this demographic change is having an important impact on all aspects of health statistics and medical care. Recently, several papers have been published from a cohort of 1,742 citizens of Bambuí, a small town in Minas Gerais. All of these people are over 60 years old and they have been followed up yearly since 1996. The conclusions from these studies have been useful in understanding the burden of increasingly elderly people in Brazil. Lower family income was independently associated with less consumption of fresh fruits or vegetables and less frequent exercise during leisure time, inability to perform routine activities because of a health problem, higher quantities of non-prescription medications and higher numbers of hospitalizations. The prevalence of obesity was 12.5% and was positively associated with female gender, famBrazil is getting older: some lessons from the Bambuí Health and Aging Study