Sex Differences in the Prevalence of Noncommunicable Chronic Diseases and Clinical Conditions Among Individuals Aged 80 Years and Older: A Multicenter Cohort Study

Sex Differences in the Prevalence of Noncommunicable Chronic Diseases and Clinical Conditions Among Individuals Aged 80 Years and Older: A Multicenter Cohort Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Sex Differences in the Prevalence of Noncommunicable Chronic Diseases and Clinical Conditions Among Individuals Aged 80 Years and Older: A Multicenter Cohort Study Nádia Marisa Sotério de Oliveira, Flávia de Araújo Cordeiro Valentim, and 12 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7115669/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background: Sex differences in the prevalence and impact of chronic conditions are well documented in older adults but remain underexplored among those aged 80 years and older. Noncommunicable chronic diseases (NCDs) significantly impact health and mortality, particularly among the oldest-old (≥80 years), who often experience concurrent age-related functional decline. While they are multifactorial, many NCDs and associated clinical conditions can be prevented or managed through lifestyle modifications, promoting higher-quality aging. Objective: To analyze the prevalence of NCDs and related clinical conditions, with a focus on sex differences, within a multicenter cohort of individuals aged ≥ 80 years. Methods: A cross-sectional analysis of data from a multicenter cohort study was performed. Prevalence rates were calculated and compared between women and men. Results: Significant sex differences were observed. Women had substantially greater prevalences of hypertension (70% vs. 60%, p=0.008), urinary incontinence (61% vs. 44%, p<0.001), osteoporosis (35% vs. 11%, p<0.001), depression (32% vs. 14%, p<0.001), and rheumatoid arthritis (32% vs. 17%, p<0.001). Conversely, men had significantly greater prevalences of diabetes mellitus (34% vs. 26%, p=0.022), ischemic stroke (19% vs. 13%, p=0.023), cancer (18% vs. 8%, p<0.001), and dysphagia (37% vs. 29%, p=0.03). Memory difficulties and chronic pain were also highly prevalent in both sexes, affecting more than half of the sample. Conclusion: The high prevalence of conditions such as hypertension and urinary incontinence in women, and diabetes and cancer in men, alongside the heavy burden of chronic pain and memory difficulties in both sexes, reinforces the need for targeted public health strategies, considering the distinct vulnerabilities between sexes in the oldest-old population. Oldest Old Sex Differences Noncommunicable Diseases Prevalence Geriatrics Epidemiology Figures Figure 1 Introduction The rapid aging of the global population has raised increasing concerns among policymakers due to its economic and health implications, as the global proportion of individuals aged ≥ 60 years is expected to nearly double from 12% to 22% between 2015 and 2050. It is estimated that by 2050, 80% of older adults will live in low- and middle-income countries [1, 2]. Although the number of studies focusing on older populations has increased, individuals aged ≥ 80 years remain underrepresented in research, including clinical trials[3, 4]. Most population-based or multicenter studies focus on older adults aged 60 or 65 and above, which limits the comparability of results for more advanced age groups. As longevity and life expectancy continues to increase, research specifically addressing the health profiles of individuals aged 80 ≥ 80 years will become increasingly relevant and necessary, helping to fill this important scientific gap. Recent data show that life expectancy in Brazil reached 76.4 years in 2023, but healthy life expectancy remains considerably lower [3]. Non-communicable chronic diseases (NCDs) significantly contribute to morbidity, functional decline, dependency, and reduced quality of life, imposing a substantial socioeconomic burden during adulthood and old age [3, 5-7]. Hypertension, for instance, affects 60.9% of Brazilian older adults and is a major risk factor for cardiovascular events such as myocardial infarction, stroke, and heart failure [6, 8]. The complex interaction of multiple factors, biological, social, economic, and cultural, shapes health in later life. [8, 9]. A Brazilian study highlighted significant gender disparities in the prevalence of NCDs among older adults, emphasizing the importance of understanding sociodemographic determinants to reduce health inequities and disease burden, particularly among individuals with multimorbidity[10]. By addressing the heterogeneity of this population, we aim to support the development of health profiles and public policies that promote autonomy, well-being, and dignity in advanced old age. The objective of this study is to identify sex differences in sociodemographic characteristics, NCD prevalence, and health conditions among Brazilian community-dwelling adults aged ≥ 80 years [4, 11]. METHODS Study Design and Participants This analytical, cross-sectional study used data from the multicenter project “Patterns of physical, cognitive, and psychosocial aging among the oldest-old living in different contexts” conducted under the National Academic Cooperation Program (PROCAD) and funded by Coordination for the Improvement of Higher Education Personnel (CAPES). The dataset included 791 community-dwelling adults aged ≥ 80 years from Brasília (n=196), Passo Fundo (n=272), and Campinas (n=323), collected between 2016 and 2018. Ethical Approval The study was approved by the Ethics Committees of Universities Passo Fundo (2.097.27/2017), Brasília (1.290.368/2015), and Campinas (3.061.534/2018), in compliance with Brazilian National Research Council guidelines. All the participants provided signed informed consent. The protocol was registered on the national ethics platform (CAAE 49987615.300005404, approval nº 1.332.651, Nov 23, 2015). Eligibility and exclusion criteria The inclusion criteria were age ≥ 80 years, preserved comprehension, and consent to participate. The exclusion criteria were as follows: inability to walk, major stroke sequelae (e.g., hemiparesis, aphasia), severe motor/speech impairment (e.g., Parkinson’s disease), profound sensory deficits, or bedridden status. Study Outcomes The primary outcomes included the sex-specific prevalence of NCDs, selected health conditions, and sociodemographic profiles. Data Analysis and Statistical Methods Missing data (18.7%), assumed missing at random (MAR), were handled via multiple imputation by chained equations (MICE), per Harrell’s guidelines. This approach aims to minimize bias, preserve variability, and provide robust results [12]. Descriptive statistics summarized variables. Categorical variables were analysed via chi‐square or Fisher’s exact test; continuous/ordinal variables with the Wilcoxon rank-sum test. Statistical significance: p <0.05. RESULTS Among the 791 individuals aged≥ 80, 71.1% were women. Significant sex differences were observed in terms of age, marital status, and education – women were older, more often widowed, and had fewer years of formal education. Most participants self-identified as White, lived with others, and reported household income up to five minimum wages. Hypertension (67.5%) was the most prevalent chronic disease, followed by diabetes mellitus, osteoporosis, and depression. Women had higher prevalences of hypertension, osteoporosis, rheumatoid arthritis, depression, and urinary incontinence; men had higher rates of diabetes, cancer, stroke, and dysphagia. Memory issues and chronic pain were common in both sexes, but the differences were not significant. The detailed results are shown in Table 1 and Figure 1. Table 01 – Sociodemographic and health characteristics by sex in Brazilian oldest -old (≥80 years; n = 791) Variable Women (%) (n=563) Men (%) (n=228) p-value Sociodemographic characteristics Study site <0.001 a Campinas 220 (39%) 103 (45%) Passo Fundo 218 (39%) 54 (24%) Brasília 125 (22%) 71 (31%) Age, median (IQR) 85 (82, 89) 84 (82, 87) 0.009 b Marital Status <0.001 a Married 69 (12%) 84 (37%) Divorced 30 (5.3%) 12 (5.3%) Single 97 (17%) 58 (25%) Widowed 367 (65%) 74 (32%) Race/skin color 0.45 a Yellow 7 (1.2%) 1 (0.4%) White 435 (77%) 166 (73%) Indigenous 7 (1.2%) 3 (1.3%) Brown/Mulato 76 (13%) 41 (18%) Black 38 (6.7%) 17 (7.5%) Literacy 444 (79%) 180 (79%) 0.98 a Years of education, median (IQR) 3 (0, 4) 4 (1, 5) 0.048 b Living alone 197 (35%) 67 (29%) 0.13 a Income-based MW † , median (IQR) 2.00 (1.07, 4.00) 2.15 (1.87, 4.00) 0.12 b Noncommunicable diseases Heart disease 124 (22%) 65 (29%) 0.053 a Hypertension 396 (70%) 138 (61%) 0.008 a Ischemic stroke 73 (13%) 44 (19%) 0.023 a Diabetes mellitus 147 (26%) 78 (34%) 0.022 a Cancer 45 (8.0%) 41 (18%) <0.001 a Rheumatoid arthritis 181 (32%) 38 (17%) <0.001 a Pulmonary disease 60 (11%) 33 (14%) 0.13 a Depression 181 (32%) 32 (14%) <0.001 a Osteoporosis 197 (35%) 25 (11%) <0.001 a Other Health Conditions Urinary incontinence 335 (61%) 101 (44%) <0.001 a Appetite loss 221 (39%) 93 (41%) 0.689 a Memory difficulties 379 (67%) 143 (63%) 0.216 a Skin lesions 173 (31%) 64 (28%) 0.460 a Food stuck sensation 211 (37%) 96 (42%) 0.226 a Food regurgitation 181 (32%) 86 (38%) 0.133 a Dysphagia 163 (29%) 84 (37%) 0.030 a Chronic pain 303 (54%) 115 (50%) 0.388 a Source: Prepared by the author a Pearson’s chi-square or Fisher’s exact test, as appropriate. b Wilcoxon rank-sum test (Mann-Whitney U test). † Income expressed in Brazilian minimum wages (MW); US$ 235.23 as of 2021. DISCUSSION Identifying the sociodemographic profile and the prevalence of non-communicable chronic diseases (NCDs) and health conditions in the oldest-old is essential for developing effective public health policies, guiding individualized prevention and treatment strategies, and informing resource allocation. Observed sex differences in prevalence help reveal specific vulnerabilities and support the formulation of more equitable and targeted interventions to promote quality of life and dignity in advanced age. In Brazil, only 11.3% of the population aged 60 years or older lives below the poverty line, largely due to pensions and social benefits indexed to the minimum wage. Nonetheless, the present sample showed a predominance of low-income individuals (≤ five minimum wages), despite residing in some of the country’s wealthiest regions. It is often observed that the income of older adults serves as the primary source of financial support for extended families. The higher representation of White women in our sample aligns with their greater longevity when compared to Black and Brown individuals—who comprise 56.5% of the Brazilian population yet face disproportionately higher rates of poverty (70%) and premature mortality [3]. Hypertension, memory complaints, urinary incontinence, and chronic pain were highly prevalent in both sexes (above 40%). Women showed higher prevalence rates than men, with statistically significant differences in hypertension and urinary incontinence, consistent with previous studies.[3, 7, 8, 13, 14]. Although combined antihypertensive therapy has demonstrated better blood pressure control, older women experience poorer outcomes despite similar treatment adherence. [15, 16]. Uncertainty around treatment targets in this age group, compounded by frailty and multimorbidity, demands individualized, evidence-based approaches [2, 5, 8, 17]. Among the most frequent NCDs after hypertension were diabetes, osteoporosis, rheumatoid arthritis, depression, ischemic stroke, and cancer. Diabetes, stroke, and cancer were more prevalent in men, while the others were more common in women (p < 0.05), reflecting trends reported in the literature [2, 3, 7, 8, 13, 18, 19]. National data show a decline in hypertension prevalence but rising rates of diabetes, musculoskeletal disorders, and depression [20]. The higher prevalence of diabetes in men is consistent with findings from Brazilian studies in octogenarian populations [14, 20, 21]. Studies involving individuals aged ≥ 80 years have similarly shown higher diabetes prevalence among men (30.2% vs. 24.7%), although other factors, such as female sex, urban residence, older age, and poor sleep quality, have also been implicated[22-24]. In contrast, data from Germany indicate higher prevalence among women (34% vs. 32%) [25]. Cancer was more prevalent among men in our study, in line with national trends showing greater cancer incidence in older, urban-dwelling White men aged ≥ 75 years [14]. The risk of ischemic stroke doubles with each decade after age 55, making aging the most significant non-modifiable risk factor. In our sample, stroke prevalence was higher among men (19% vs. 13%), which is consistent with existing evidence that identifies hypertension, diabetes, and obesity as key modifiable risk factors [26]. The high prevalence of chronic pain, often linked to musculoskeletal diseases, was observed in both sexes. It may also be associated with other conditions such as depression, rheumatoid arthritis, diabetes, and stroke sequelae, highlighting the need for proper identification and management. Chronic pain negatively affects functional capacity and quality of life, especially among frail older adults [13, 27, 28]. Considering the physical, emotional, and social impact of pain, comprehensive and individualized pain management strategies are warranted in this age group. Rheumatoid arthritis affects women more frequently, and therapeutic challenges and worse prognoses persist after age 65, including greater functional impairment and increased cardiovascular risk [19]. The higher prevalence of depression among women may be associated with age, marital status, level of education, dissatisfaction with life and multimorbidity (osteoporosis, rheumatoid arthritis and chronic pain) [19, 27, 28]. Some limitations must be acknowledged. First, this study focused exclusively on community-dwelling individuals aged ≥80 years, whose generational characteristics may reflect unique historical, cultural, and socioeconomic influences. Second, data were collected in urban areas of more affluent regions and in different contexts across study sites, including home-based interviews (Campinas), outpatient services (Brasília), and long-term care facilities (Passo Fundo), which may limit comparability and generalizability. Third, the use of self-reported information may have introduced recall and reporting bias. Future research should incorporate longitudinal designs and mixed-method approaches to improve disease monitoring and optimize late-life care. Our findings underscore the need for sex-specific prevention strategies, early diagnosis, and comprehensive management of chronic conditions affecting functional capacity and quality of life in the oldest-old. Promoting age-friendly environments, continued professional training, and intersectoral policies is essential to reduce disability and support active, dignified aging, in line with World Health Organization recommendations. CONCLUSION We identified significant sex differences in the prevalence of several chronic diseases and health conditions among the oldest-aged individuals. Women presented higher rates of hypertension, urinary incontinence, osteoporosis, rheumatoid arthritis, and depression, whereas men presented higher prevalences of diabetes, cancer, ischemic stroke, and dysphagia. Memory difficulties and chronic pain were also highly prevalent but did not differ by sex. Although these findings are consistent with broader findings, few investigations focus exclusively on adults aged ≥80 years, underscoring the value of this research. ABREVIATIONS CAAE: Certificado de Apresentação de Apreciação Ética / Certificate of Presentation of Ethical Appreciation CAPES: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Coordination for the Improvement of Higher Education Personnel MAR: Missing at random MICE: Multiple imputation by chained equations NCDs: Non-communicable chronic diseases PROCAD: National Academic Cooperation Program Declarations Ethics approval and consent to participate The study was approved by the Ethics Committees of Universities Passo Fundo (2.097.27/2017), Brasília (1.290.368/2015), and Campinas (3.061.534/2018), in compliance with Brazilian National Research Council guidelines. All the participants provided signed informed consent. The protocol was registered on the national ethics platform (CAAE 49987615.300005404, approval nº 1.332.651, Nov 23, 2015). Consent for publication Not applicable. Availability of data and materials The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Competing interests The authors declare no competing interests. Funding This research did not receive specific funding from public, commercial, or no-profit funding agencies. Contribuitions Nádia M. Sotério de Oliveira and Luiz Sérgio F. de Carvalho conceived, designed conducted the data analysis and interpretation, and drafted the manuscript. Karla H. C. Vilaça, Vicente Paulo Alves e Clayton F. de Moraes contributed to data acquisition and quality control. Flavia de Araújo C. Valentim, Thaiene M. M. Severino, Robson C. Silva, Lucila de J. Almeida, Cristiane Koeche, Ana Claudia C. Nogueira, Sérgio Henrique R. Ramalho, Alessandra M. Campos-Staffico, Alexandre A. S.M. Soares contributed to the critical revision of the manuscript. All authors read and approved the final version of the manuscript. References Harper S. 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Santiago BVM, Oliveira ABGd, Silva GMRd, Silva MdFd, Bergamo PE, Parise M, et al. Prevalence of chronic pain in Brazil: A systematic review and metaanalysis. Clinics. 2023 doi: https://doi.org/10.1016/j.clinsp.2023.100209. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 20 Oct, 2025 Reviewers agreed at journal 17 Oct, 2025 Reviewers invited by journal 06 Oct, 2025 Editor invited by journal 02 Sep, 2025 Editor assigned by journal 15 Jul, 2025 Submission checks completed at journal 15 Jul, 2025 First submitted to journal 13 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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M.","lastName":"Soares","suffix":""},{"id":530660218,"identity":"5300cbed-dbec-47cb-b8d9-d2aed4a97a00","order_by":10,"name":"Karla Helena Coelho Vilaça e Silva","email":"","orcid":"","institution":"Catholic University of Brasília (UCB)","correspondingAuthor":false,"prefix":"","firstName":"Karla","middleName":"Helena Coelho Vilaça e","lastName":"Silva","suffix":""},{"id":530660219,"identity":"21358457-827a-4bd7-8485-11c03115ba69","order_by":11,"name":"Vicente Paulo Alves","email":"","orcid":"","institution":"Catholic University of Brasília (UCB)","correspondingAuthor":false,"prefix":"","firstName":"Vicente","middleName":"Paulo","lastName":"Alves","suffix":""},{"id":530660220,"identity":"cae16f50-2334-40f5-8e59-86692731e229","order_by":12,"name":"Clayton Franco Moraes","email":"","orcid":"","institution":"Catholic University of Brasília (UCB)","correspondingAuthor":false,"prefix":"","firstName":"Clayton","middleName":"Franco","lastName":"Moraes","suffix":""},{"id":530660221,"identity":"e8f959cc-f36c-4b37-9ac1-830523766e34","order_by":13,"name":"Luiz Sérgio Fernandes Carvalho","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA5UlEQVRIie3PvQrCMBSG4RMCukS7tghew3F08VpaOrj5swkWjAh1dK0gXoNTJ4eWQrvU3cHBInSud2AqorjEugnmHcI35CEEQKX6wZpA+GNSF2BSDgZURmovQgRJK5FngpTqM9HtRQFOb4hJ6J6v2xNgcgjoeC8jFkeI7e4utZadtZ8DpgOTermcmIRTNLjlthp+BHhkSFkgJwHhMzRWmSCbamTOCY9Q08tXeBXCsgWYcSJI5hpenDND/CXyJESr9y9F4UyxptmxXjindjM5hJeRhNwzXzNg9/MDeOuryyqVSvUn3QApfk2oTt5sbAAAAABJRU5ErkJggg==","orcid":"","institution":"Catholic University of Brasília (UCB)","correspondingAuthor":true,"prefix":"","firstName":"Luiz","middleName":"Sérgio Fernandes","lastName":"Carvalho","suffix":""}],"badges":[],"createdAt":"2025-07-13 23:38:10","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7115669/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7115669/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":93758488,"identity":"6a18975e-e5b2-4ca8-98aa-d8227faec0ea","added_by":"auto","created_at":"2025-10-17 09:10:27","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":117300,"visible":true,"origin":"","legend":"","description":"","filename":"Manuscrit.docx","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/4c3835b0da6f3f9870e68d6d.docx"},{"id":93758871,"identity":"48a0acb8-6057-4d58-ae2a-a0cfecabbf7d","added_by":"auto","created_at":"2025-10-17 09:18:27","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":14042,"visible":true,"origin":"","legend":"","description":"","filename":"1ab6fca127434cf48b83ed67ffcef20e.json","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/51b0e736cbeca94312a2197c.json"},{"id":93758872,"identity":"6584ea0a-586c-45f6-804f-9c556788fc44","added_by":"auto","created_at":"2025-10-17 09:18:27","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":90289,"visible":true,"origin":"","legend":"","description":"","filename":"1ab6fca127434cf48b83ed67ffcef20e1enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/9feaa7cbb95f5c223b2560a8.xml"},{"id":93758490,"identity":"d64b5ceb-ea08-4dbd-99fe-ac1cd1b7e362","added_by":"auto","created_at":"2025-10-17 09:10:27","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":87223,"visible":true,"origin":"","legend":"","description":"","filename":"1ab6fca127434cf48b83ed67ffcef20e1structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/54100251872b45ede46f1afa.xml"},{"id":93759878,"identity":"8a3fb72d-4afb-48cc-87dc-cab7a56d1645","added_by":"auto","created_at":"2025-10-17 09:26:27","extension":"html","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":99485,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/e0ab183e35d7c400d16ecda9.html"},{"id":93758487,"identity":"3fdf85e6-cf83-4a4e-9a65-92fca665fa96","added_by":"auto","created_at":"2025-10-17 09:10:27","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":20809,"visible":true,"origin":"","legend":"\u003cp\u003eSex differences in the prevalence of chronic diseases (NCDs) and health conditions among in Brazilian oldest-old (≥80 years; n = 791).\u003c/p\u003e\n\u003cp\u003eSex differences in the prevalence of non-communicable chronic diseases (NCDs) and health-related conditions among community-dwelling older adults aged ≥80 years in Brazil (n = 791). Percentages represent condition-specific prevalence by sex. *Statistically significant difference in favor of women (p \u0026lt; 0.05). **Statistically significant difference in favor of men (p \u0026lt; 0.05). Statistical tests: Pearson’s chi-square or Fisher’s exact test, as appropriate.\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/761324adbccfb2e76a1f8f64.png"},{"id":93760006,"identity":"f99fb8d5-3845-4acb-be6e-bd258cf05003","added_by":"auto","created_at":"2025-10-17 09:34:28","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1012706,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7115669/v1/2ed4f67f-cba8-4f8a-addb-e714b0563cf5.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Sex Differences in the Prevalence of Noncommunicable Chronic Diseases and Clinical Conditions Among Individuals Aged 80 Years and Older: A Multicenter Cohort Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe rapid aging of the global population has raised increasing concerns among policymakers due to its economic and health implications, as the global proportion of individuals aged ≥ 60 years is expected to nearly double from 12% to 22% between 2015 and 2050. It is estimated that by 2050, 80% of older adults will live in low- and middle-income countries [1, 2]. Although the number of studies focusing on older populations has increased, individuals aged ≥ 80 years remain underrepresented in research, including clinical trials[3, 4]. Most population-based or multicenter studies focus on older adults aged 60 or 65 and above, which limits the comparability of results for more advanced age groups. As longevity and life expectancy continues to increase, research specifically addressing the health profiles of individuals aged 80 ≥ 80 years will become increasingly relevant and necessary, helping to fill this important scientific gap.\u003c/p\u003e\n\u003cp\u003eRecent data show that life expectancy in Brazil reached 76.4 years in 2023, but healthy life expectancy remains considerably lower [3]. Non-communicable chronic diseases (NCDs) significantly contribute to morbidity, functional decline, dependency, and reduced quality of life, imposing a substantial socioeconomic burden during adulthood and old age [3, 5-7]. Hypertension, for instance, affects 60.9% of Brazilian older adults and is a major risk factor for cardiovascular events such as myocardial infarction, stroke, and heart failure [6, 8]. \u003c/p\u003e\n\u003cp\u003eThe complex interaction of multiple factors, biological, social, economic, and cultural, shapes health in later life. [8, 9]. A Brazilian study highlighted significant gender disparities in the prevalence of NCDs among older adults, emphasizing the importance of understanding sociodemographic determinants to reduce health inequities and disease burden, particularly among individuals with multimorbidity[10].\u003c/p\u003e\n\u003cp\u003eBy addressing the heterogeneity of this population, we aim to support the development of health profiles and public policies that promote autonomy, well-being, and dignity in advanced old age. The objective of this study is to identify sex differences in sociodemographic characteristics, NCD prevalence, and health conditions among Brazilian community-dwelling adults aged ≥ 80 years [4, 11].\u003c/p\u003e"},{"header":"METHODS","content":"\u003cp\u003e\u003cstrong\u003eStudy Design and Participants\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis analytical, cross-sectional study used data from the multicenter project \u0026nbsp;“Patterns of physical, cognitive, and psychosocial aging among the oldest-old living in different contexts” conducted under the National Academic Cooperation Program (PROCAD) and funded by Coordination for the Improvement of Higher Education Personnel (CAPES). The dataset included 791 community-dwelling adults aged ≥ 80 years from Brasília (n=196), Passo Fundo (n=272), and Campinas (n=323), collected between 2016 and 2018.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committees of Universities Passo Fundo (2.097.27/2017), Brasília (1.290.368/2015), and Campinas (3.061.534/2018), in compliance with Brazilian National Research Council guidelines. All the participants provided signed informed consent. The protocol was registered on the national ethics platform (CAAE 49987615.300005404, approval nº 1.332.651, Nov 23, 2015).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEligibility and exclusion criteria\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe inclusion criteria were age ≥ 80 years, preserved comprehension, and consent to participate.\u0026nbsp;The exclusion criteria were as follows: inability to walk, major stroke sequelae (e.g., hemiparesis, aphasia), severe motor/speech impairment (e.g., Parkinson’s disease), profound sensory deficits, or bedridden status.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy Outcomes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe primary outcomes included the sex-specific prevalence of NCDs, selected health conditions, and sociodemographic profiles.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analysis and Statistical Methods\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eMissing data (18.7%), assumed missing at random (MAR), were handled via multiple imputation by chained equations (MICE), per Harrell’s guidelines. This approach aims to minimize bias, preserve variability, and provide robust results\u0026nbsp;[12]. Descriptive statistics summarized variables. Categorical variables were analysed via chi‐square or Fisher’s exact test; continuous/ordinal variables with the Wilcoxon rank-sum test. Statistical significance: \u003cem\u003ep\u003c/em\u003e\u0026lt;0.05.\u003c/p\u003e"},{"header":" RESULTS ","content":"\u003cp\u003eAmong the 791 individuals aged\u0026ge; 80,\u0026nbsp;71.1% were women. Significant sex differences were observed in terms of age, marital status, and education \u0026ndash; women were older, more often widowed, and had fewer years of formal education. Most participants self-identified as White, lived with others, and reported household income up to five minimum wages. Hypertension (67.5%) was the most prevalent chronic disease, followed by diabetes mellitus, osteoporosis, and depression. Women had higher prevalences of hypertension, osteoporosis, rheumatoid arthritis, depression, and urinary incontinence; men had higher rates of diabetes, cancer, stroke, and dysphagia. Memory issues and chronic pain were common in both sexes, but the differences were not significant. The detailed results are shown in Table 1 and Figure 1.\u003c/p\u003e\n\u003cp\u003eTable 01 \u0026ndash; Sociodemographic and health characteristics by sex in Brazilian oldest -old (\u0026ge;80 years; n = 791)\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\" width=\"529\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eWomen (%) (n=563)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMen (%) (n=228)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ep-value\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSociodemographic characteristics\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudy site\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eCampinas\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e220 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e103 (45%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003ePasso Fundo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e218 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e54 (24%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eBras\u0026iacute;lia\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e125 (22%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e71 (31%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge, median (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e85 (82, 89)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e84 (82, 87)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.009\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMarital Status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eMarried\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e69 (12%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e84 (37%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eDivorced\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e30 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e12 (5.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eSingle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e97 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e58 (25%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eWidowed\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e367 (65%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e74 (32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRace/skin color\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.45\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eYellow\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e1 (0.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eWhite\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e435 (77%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e166 (73%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eIndigenous\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e7 (1.2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3 (1.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eBrown/Mulato\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e76 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e41 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eBlack\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e38 (6.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e17 (7.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiteracy\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e444 (79%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e180 (79%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.98\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eYears of education, median (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e3 (0, 4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4 (1, 5)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.048\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiving alone\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e197 (35%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e67 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.13\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIncome-based MW\u003csup\u003e\u0026dagger;\u003c/sup\u003e, median (IQR)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2.00 (1.07, 4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e2.15 (1.87, 4.00)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.12\u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eNoncommunicable diseases\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHeart disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e124 (22%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e65 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.053\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e396 (70%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e138 (61%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.008\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eIschemic stroke\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e73 (13%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e44 (19%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.023\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes mellitus\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e147 (26%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e78 (34%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.022\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCancer\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e45 (8.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e41 (18%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eRheumatoid arthritis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e181 (32%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e38 (17%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePulmonary disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e60 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e33 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.13\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDepression\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e181 (32%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e32 (14%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOsteoporosis\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e197 (35%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e25 (11%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 321px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther Health Conditions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eUrinary incontinence\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e335 (61%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e101 (44%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026lt;0.001\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAppetite loss\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e221 (39%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e93 (41%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.689\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMemory difficulties\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e379 (67%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e143 (63%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.216\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSkin lesions\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e173 (31%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e64 (28%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.460\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFood stuck sensation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e211 (37%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e96 (42%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.226\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFood regurgitation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e181 (32%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e86 (38%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.133\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDysphagia\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e163 (29%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e84 (37%)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.030\u003csup\u003ea\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic pain\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e303 (54%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 123px;\"\u003e\n \u003cp\u003e115 (50%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 85px;\"\u003e\n \u003cp\u003e0.388\u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"4\" valign=\"top\" style=\"width: 529px;\"\u003e\n \u003cp\u003eSource: Prepared by the author\u003c/p\u003e\n \u003cp\u003e\u003csup\u003ea\u0026nbsp;\u003c/sup\u003ePearson\u0026rsquo;s chi-square or Fisher\u0026rsquo;s exact test, as appropriate. \u003csup\u003eb\u0026nbsp;\u003c/sup\u003eWilcoxon rank-sum test (Mann-Whitney U test).\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003csup\u003e\u0026dagger;\u0026nbsp;\u003c/sup\u003e Income expressed in Brazilian minimum wages (MW); US$ 235.23 as of 2021.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Identifying the sociodemographic profile and the prevalence of non-communicable chronic diseases (NCDs) and health conditions in the oldest-old is essential for developing effective public health policies, guiding individualized prevention and treatment strategies, and informing resource allocation. Observed sex differences in prevalence help reveal specific vulnerabilities and support the formulation of more equitable and targeted interventions to promote quality of life and dignity in advanced age.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;In Brazil, only 11.3% of the population aged 60 years or older lives below the poverty line, largely due to pensions and social benefits indexed to the minimum wage. Nonetheless, the present sample showed a predominance of low-income individuals (≤ five minimum wages), despite residing in some of the country’s wealthiest regions. It is often observed that the income of older adults serves as the primary source of financial support for extended families. The higher representation of White women in our sample aligns with their greater longevity when compared to Black and Brown individuals—who comprise 56.5% of the Brazilian population yet face disproportionately higher rates of poverty (70%) and premature mortality [3].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Hypertension, memory complaints, urinary incontinence, and chronic pain were highly prevalent in both sexes (above 40%). Women showed higher prevalence rates than men, with statistically significant differences in hypertension and urinary incontinence, consistent with previous studies.[3, 7, 8, 13, 14]. Although combined antihypertensive therapy has demonstrated better blood pressure control, older women experience poorer outcomes despite similar treatment adherence. [15, 16]. \u0026nbsp;Uncertainty around treatment targets in this age group, compounded by frailty and multimorbidity, demands individualized, evidence-based approaches [2, 5, 8, 17].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Among the most frequent NCDs after hypertension were diabetes, osteoporosis, rheumatoid arthritis, depression, ischemic stroke, and cancer. Diabetes, stroke, and cancer were more prevalent in men, while the others were more common in women (p \u0026lt; 0.05), reflecting trends reported in the literature [2, 3, 7, 8, 13, 18, 19]. National data show a decline in hypertension prevalence but rising rates of diabetes, musculoskeletal disorders, and depression [20]. The higher prevalence of diabetes in men is consistent with findings from Brazilian studies in octogenarian populations [14, 20, 21]. Studies involving individuals aged ≥ 80 years have similarly shown higher diabetes prevalence among men (30.2% vs. 24.7%), although other factors, such as female sex, urban residence, older age, and poor sleep quality, have also been implicated[22-24]. In contrast, data from Germany indicate higher prevalence among women (34% vs. 32%) [25].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Cancer was more prevalent among men in our study, in line with national trends showing greater cancer incidence in older, urban-dwelling White men aged ≥ 75 years [14]. The risk of ischemic stroke doubles with each decade after age 55, making aging the most significant non-modifiable risk factor. In our sample, stroke prevalence was higher among men (19% vs. 13%), which is consistent with existing evidence that identifies hypertension, diabetes, and obesity as key modifiable risk factors [26].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;The high prevalence of chronic pain, often linked to musculoskeletal diseases, was observed in both sexes. It may also be associated with other conditions such as depression, rheumatoid arthritis, diabetes, and stroke sequelae, highlighting the need for proper identification and management. Chronic pain negatively affects functional capacity and quality of life, especially among frail older adults [13, 27, 28]. Considering the physical, emotional, and social impact of pain, comprehensive and individualized pain management strategies are warranted in this age group. \u0026nbsp;Rheumatoid arthritis affects women more frequently, and therapeutic challenges and worse prognoses persist after age 65, including greater functional impairment and increased cardiovascular risk [19]. The higher prevalence of depression among women may be associated with age, marital status, level of education, dissatisfaction with life and multimorbidity (osteoporosis, rheumatoid arthritis and chronic pain) [19, 27, 28].\u003c/p\u003e\n\u003cp\u003eSome limitations must be acknowledged. First, this study focused exclusively on community-dwelling individuals aged ≥80 years, whose generational characteristics may reflect unique historical, cultural, and socioeconomic influences. Second, data were collected in urban areas of more affluent regions and in different contexts across study sites, including home-based interviews (Campinas), outpatient services (Brasília), and long-term care facilities (Passo Fundo), which may limit comparability and generalizability. Third, the use of self-reported information may have introduced recall and reporting bias.\u003c/p\u003e\n\u003cp\u003eFuture research should incorporate longitudinal designs and mixed-method approaches to improve disease monitoring and optimize late-life care. Our findings underscore the need for sex-specific prevention strategies, early diagnosis, and comprehensive management of chronic conditions affecting functional capacity and quality of life in the oldest-old. Promoting age-friendly environments, continued professional training, and intersectoral policies is essential to reduce disability and support active, dignified aging, in line with World Health Organization recommendations.\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eWe identified significant sex differences in the prevalence of several chronic diseases and health conditions among the oldest-aged individuals. Women presented higher rates of hypertension, urinary incontinence, osteoporosis, rheumatoid arthritis, and depression, whereas men presented higher prevalences of diabetes, cancer, ischemic stroke, and dysphagia. Memory difficulties and chronic pain were also highly prevalent but did not differ by sex. Although these findings are consistent with broader findings, few investigations focus exclusively on adults aged ≥80 years, underscoring the value of this research.\u003c/p\u003e"},{"header":"ABREVIATIONS ","content":"\u003cp\u003eCAAE: Certificado de Apresentação de Apreciação Ética / Certificate of Presentation of Ethical Appreciation\u003c/p\u003e\n\u003cp\u003eCAPES: Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Coordination for the Improvement of Higher Education Personnel\u003c/p\u003e\n\u003cp\u003eMAR: Missing at random\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eMICE: Multiple imputation by chained equations\u003c/p\u003e\n\u003cp\u003eNCDs:\u0026nbsp;Non-communicable chronic diseases\u003c/p\u003e\n\u003cp\u003ePROCAD: National Academic Cooperation Program\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Ethics Committees of Universities Passo Fundo (2.097.27/2017), Brasília (1.290.368/2015), and Campinas (3.061.534/2018), in compliance with Brazilian National Research Council guidelines. All the participants provided signed informed consent. The protocol was registered on the national ethics platform (CAAE 49987615.300005404, approval nº 1.332.651, Nov 23, 2015).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Funding\u0026nbsp;\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThis research did not receive specific funding from public, commercial, or no-profit funding agencies.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eContribuitions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNádia M. Sotério de Oliveira and Luiz Sérgio F. de Carvalho conceived, designed conducted the data analysis and interpretation, and drafted the manuscript. Karla H. C. Vilaça, Vicente Paulo Alves e Clayton F. de Moraes contributed to data acquisition and quality control. Flavia de Araújo C. Valentim, Thaiene M. M. Severino, Robson C. Silva, Lucila de J. Almeida, Cristiane Koeche, Ana Claudia C. Nogueira, Sérgio Henrique R. Ramalho, Alessandra M. Campos-Staffico, Alexandre A. S.M. Soares contributed to the critical revision of the manuscript. All authors read and approved the final version of the manuscript.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eHarper S. Economic and social implications of aging societies. Science. 2014 doi: 10.1126/science.1254405.\u003c/li\u003e\n\u003cli\u003eWorld Health Organization (WHO). Ageing and health. https://www.who.int/news-room/fact-sheets/detail/ageing-and-health (2024). 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PLOS ONE. 2024;19(10):e0309837. doi: 10.1371/journal.pone.0309837.\u003c/li\u003e\n\u003cli\u003eAmerican Diabetes Association. 12. Older Adults: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 doi: 10.2337/dc21-S012.\u003c/li\u003e\n\u003cli\u003eFrancisco PMSB, Assump\u0026ccedil;\u0026atilde;o Dd, Bacurau AGdM, da Silva DSM, Yassuda MS, Borim FSA. Diabetes mellitus em idosos, preval\u0026ecirc;ncia e incid\u0026ecirc;ncia: resultados do Estudo Fibra. Rev Bras Geriatr Gerontol. 2022;25(5):e210203. doi: http://dx.doi.org/10.1590/1981-22562022025.210203.pt.\u003c/li\u003e\n\u003cli\u003eHu X, Meng L, Wei Z, Xu H, Li J, Li Y, et al. Prevalence and potential risk factors of self-reported diabetes among elderly people in China: A national cross-sectional study of 224,142 adults. Frontiers in Public Health. 2022 doi: https://doi.org/10.3389/fpubh.2022.1051445.\u003c/li\u003e\n\u003cli\u003eNaito H, Kaga H, Someya Y, Tabata H, Kakehi S, Yoshizawa Y, et al. 1216-P: Effects of Aging after Age 65 on Glucose Tolerance, Insulin Sensitivity, and \u0026szlig;-Cell Function in Japanese\u0026mdash;The Bunkyo Health Study. Diabetes. 2023;72(Supplement_1):1216\u0026ndash;P. doi: https://doi.org/10.2337/db23-1216-P.\u003c/li\u003e\n\u003cli\u003eZeyfang A, Wernecke J, Bahrmann A. Diabetes Mellitus at an Elderly Age. Exp Clin Endocrinol Diabetes. 2021 doi: https://doi.org/10.1055/a-1284-6023.\u003c/li\u003e\n\u003cli\u003eO\u0026apos;Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et al. Risk factors for ischaemic and intracerebral haemorrhagic stroke in 22 countries (the INTERSTROKE study): a case-control study. Lancet. 2010 doi: https://doi.org/10.1016/S0140-6736(10)60834-3.\u003c/li\u003e\n\u003cli\u003eLucas JW, Sohi I. Chronic Pain and High-impact Chronic Pain in U.S. Adults, 2023. In: NCHS Data Brief. Hyattsville, MD: National Center for Health Statistics.: 2024. doi: https://dx.doi.org/10.15620/cdc/169630. https://stacks.cdc.gov/view/cdc/169630/cdc_169630_DS1.pdf.\u003c/li\u003e\n\u003cli\u003eSantiago BVM, Oliveira ABGd, Silva GMRd, Silva MdFd, Bergamo PE, Parise M, et al. Prevalence of chronic pain in Brazil: A systematic review and metaanalysis. Clinics. 2023 doi: https://doi.org/10.1016/j.clinsp.2023.100209. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Oldest Old, Sex Differences, Noncommunicable Diseases, Prevalence, Geriatrics, Epidemiology","lastPublishedDoi":"10.21203/rs.3.rs-7115669/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7115669/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Sex differences in the prevalence and impact of chronic conditions are well documented in older adults but remain underexplored among those aged 80 years and older. Noncommunicable chronic diseases (NCDs) significantly impact health and mortality, particularly among the oldest-old (≥80 years), who often experience concurrent age-related functional decline. While they are multifactorial, many NCDs and associated clinical conditions can be prevented or managed through lifestyle modifications, promoting higher-quality aging.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjective:\u003c/strong\u003e To analyze the prevalence of NCDs and related clinical conditions, with a focus on sex differences, within a multicenter cohort of individuals aged ≥ 80 years.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e A cross-sectional analysis of data from a multicenter cohort study was performed. Prevalence rates were calculated and compared between women and men.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e Significant sex differences were observed. Women had substantially greater prevalences of hypertension (70% vs. 60%, p=0.008), urinary incontinence (61% vs. 44%, p\u0026lt;0.001), osteoporosis (35% vs. 11%, p\u0026lt;0.001), depression (32% vs. 14%, p\u0026lt;0.001), and rheumatoid arthritis (32% vs. 17%, p\u0026lt;0.001). Conversely, men had significantly greater prevalences of diabetes mellitus (34% vs. 26%, p=0.022), ischemic stroke (19% vs. 13%, p=0.023), cancer (18% vs. 8%, p\u0026lt;0.001), and dysphagia (37% vs. 29%, p=0.03). Memory difficulties and chronic pain were also highly prevalent in both sexes, affecting more than half of the sample.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThe high prevalence of conditions such as hypertension and urinary incontinence in women, and diabetes and cancer in men, alongside the heavy burden of chronic pain and memory difficulties in both sexes, reinforces the need for targeted public health strategies, considering the distinct vulnerabilities between sexes in the oldest-old population.\u003c/p\u003e","manuscriptTitle":"Sex Differences in the Prevalence of Noncommunicable Chronic Diseases and Clinical Conditions Among Individuals Aged 80 Years and Older: A Multicenter Cohort Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-17 09:10:23","doi":"10.21203/rs.3.rs-7115669/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-10-20T11:30:36+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"101914482866494642589166164892018550034","date":"2025-10-17T05:52:52+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-10-06T12:53:22+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-09-02T08:32:48+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-15T07:34:09+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-15T07:33:36+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Public Health","date":"2025-07-13T23:31:10+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-public-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"pubh","sideBox":"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/pubh/default.aspx","title":"BMC Public Health","twitterHandle":"@BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4c58c4db-96cf-4707-be6c-86793a948704","owner":[],"postedDate":"October 17th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-10-17T09:10:23+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-17 09:10:23","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7115669","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7115669","identity":"rs-7115669","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}