The accelerated aging of the Brazilian population demands a revision of educational policies and training practices in higher education. This article, prepared by the speakers of the roundtable "Portraits of Brazil – Education: How Are We in 2025?", held during the XXIV Brazilian Congress of Geriatrics and Gerontology, presents an integrated overview of geriatrics and gerontology in undergraduate courses in Brazil and brings together an analysis of the National Curricular Guidelines, a literature review on curricular implementation across multiple programs, and a mapping of Academic Leagues of Geriatrics and Gerontology as a complementary training strategy. The resulting overview reveals a heterogeneous and fragmented approach, with a lack of content standardization, gaps in the integration between theory and practice, and a shortage of qualified specialists for teaching. Academic Leagues emerge as a promising strategy, although limited by geographical concentration and insufficient preceptors. The challenges identified were organized into four axes — curriculum, human resources, research, and governance — and point to implications for educational policymakers, particularly the updating of the National Curricular Guidelines, the inclusion of aging-related training indicators in program evaluation processes, and the creation of incentive policies to enable changes on a national scale.

Keywords: aging, geriatrics, universities, curriculum, education, community-institutional relations.

Population aging places significant demands on the training of professionals specialized in geriatrics and gerontology. This article presents an updated overview of graduate degree and nondegree programs in these fields in Brazil, highlighting advances, challenges, and future perspectives. The information was compiled between 2024 and 2025 based on public sources—such as the Health Education Panel of the Ministry of Education, the Medical Demographics Census, the Brazilian Society of Geriatrics and Gerontology, and the Network of Interdisciplinary Graduate Programs on Aging (Reprinte)—, supplemented by a questionnaire sent to supervisors of some graduate programs. The findings were organized and discussed in three topic areas presented at the 2025 Brazilian Congress of Geriatrics and Gerontology: medical residency programs, multiprofessional health residency programs, and Reprinte. We identified 59 active medical residency programs in Geriatrics in Brazil, with uneven distribution and a strong concentration in the Southeast region. Key challenges include a shortage of preceptors, healthcare overload, and difficulties in integrating with care networks. In multiprofessional residency programs, interdisciplinary training and on-the-job training stand out; they also face insufficient preceptors, unstable funding, and concentration in large urban centers. The Reprinte network brings together 11 graduate degree programs, promoting scientific cooperation and academic integration. However, it faces obstacles in terms of visibility, funding, and nationwide consolidation. We conclude that strengthening graduate programs and training networks in geriatrics and gerontology is strategic to respond to the demands of an increasingly long-lived population. Continuous investment, integrated policies, and inter-institutional collaboration are required.

Keywords: Internship and residency. Aging. Geriatrics. Postgraduate programs. Non-medical residency.

OBJECTIVE: Although hypertensive older adults require physical activity, their ability to leave the house may be limited. This study’s primary objective was to determine the effect of live-streamed tele-exercise (LSTE) on the sleep quality of hypertensive older women.
METHODS: This randomized controlled clinical trial included hypertensive older women aged 60 to 79 years who were receiving drug treatment, had not been diagnosed with sleep disorders, and were not taking sedatives or hypnotics. They were evaluated with the Timed Up and Go test, the 4.6 m walk test, the Pittsburgh Sleep Quality Index, and actigraphy. They were randomly assigned to a control or an LSTE group and were reassessed after 10 weeks. The LSTE group performed at least 30 exercise sessions consisting of live-streamed online sessions held twice a week and one recorded session, while the control group was monitored through a message group.
RESULTS: The mean participant age was 69.7 (SD 4.9) years. Timed Up and Go results were lower in the LSTE group (p = 0.046), and Pittsburgh Sleep Quality Index scores were reduced in both groups. According to the actigraphy results, sleep time increased in the LSTE group (from 372.4 [SD 92.7] to 428.7 [SD 67.4] min, p = 0.044) and sleep efficiency reached a value of > 85%.
CONCLUSIONS: In hypertensive older women, a 10-week low-to-moderate intensity LSTE program resulted in increased total sleep time.

Registered in ClinicalTrials.gov platform: (NCT05991505)

Keywords: sleep quality; hypertension; exercise.

OBJECTIVE: Dementia is a leading cause of disability and dependence among older adults worldwide, with its prevalence increasing due to rising life expectancy. Evidence suggests that dementia may be preventable. In 2024, the Lancet Commission identified 14 modifiable risk factors for dementia. Investigating their impact in the oldest-old is essential to inform prevention strategies. Within this context, we sought to evaluate the association between modifiable risk factors identified by the 2024 Lancet Commission and the incidence of dementia in a cohort of cognitively healthy oldest-old Brazilians. We hypothesized that the influence of these factors may differ in very late life compared with midlife, particularly in a socioeconomically diverse Latin American population.
METHODS: This longitudinal study followed 273 participants aged 80 years and older (mean age 85.2 ± 4.48 years) between 2010 and 2020. The cohort originated from the Department of Geriatrics and Gerontology at the Escola Paulista de Medicina –Universidade Federal de São Paulo. Competing risks models (Fine and Gray) were applied to account for death and dementia. The primary outcome was incident dementia, defined as functional decline related to cognitive impairment. Kaplan-Meier curves were initially explored, followed by competing risks models. Twelve factors were evaluated: educational attainment, hypertension, hearing impairment, smoking, body mass index, depression, physical activity, diabetes, social contact, alcohol consumption, dyslipidemia, and traumatic brain injury. Analyses were conducted using RStudio (survival, survminer, cmprsk), with significance set at 5%. Participants lost to follow-up were censored, and deaths contributed data up to the last assessment.
RESULTS: During follow-up, 23.4% of participants developed dementia and 29.3% died without dementia. Low BMI (<18.5 kg/m²) was the only factor significantly associated with increased dementia risk (HR = 5.03; p = 0.02).
CONCLUSIONS: These findings highlight the relevance of nutritional status in the assessment of dementia risk among the oldest-old. Individuals aged 80 years and older may remain cognitively preserved for extended periods, underscoring the need for further research to better define risk and protective factors in this population.

Keywords: dementia, cognition, aged 80 and over, risk factors, survival analysis.

OBJECTIVE: To investigate the association between purpose in life (PIL) and symptoms of depression, anxiety, and stress in community-dwelling older adults.
METHODS: A cross-sectional study was conducted with 446 community-dwelling older adults (≥ 60 years) in Patos de Minas, Brazil. PIL was assessed using the 10-item subscale of the Purpose in Life Scale. Depression, anxiety, and stress (primary independent variables) were measured using the DASS-21. Self-perceived health, sex, age, and educational attainment were included as control variables in the regression models. Group comparison tests and Poisson regression with robust variance were applied, adopting a 5% level of statistical significance.
RESULTS: Participants with moderate to severe symptoms of depression (PR 1.99; 95% CI 1.40 – 2.83), anxiety (PR 1.71; 95% CI 1.20 – 2.45), and stress (PR 1.43; 95% CI 1.00 – 2.05) had a higher risk of low PIL. Negative self-rated health was also associated with this risk (PR 1.47; 95% CI 1.05 – 2.05), whereas higher educational attainment was associated with a lower risk (PR 0.48; 95% CI 0.23 – 0.88).
CONCLUSIONS: PIL in older adults was negatively associated with elevated symptoms of depression, anxiety, and stress, even after controlling for sociodemographic variables and subjective health perception. These findings underscore the need for integrated strategies to promote mental health and purpose in life in aging populations.

Keywords: aging; older adults; psychological well-being; mental health.

OBJECTIVE: This exploratory/pilot study analyzed the effects of a 12-week program of Amazonian dance on balance and functional performance in community-dwelling people with Parkinson's disease.
METHODS: The Amazonian dance program consisted of 2 60-minute sessions per week for 12 weeks. Balance was assessed using the Mini Balance Evaluation Systems Test, while functional performance domains were assessed using the Short Physical Performance Battery. Pre- and post-intervention parameters were compared using Student's t-test in Jamovi 2.4.14.
RESULTS: Fifteen people with Parkinson's disease (mean age 67.3 [SD 8.6] years) participated in the study. No significant responses were observed for balance (pre = 29.00 [SD, 2.45], post = 28.00 [SD 3.12], p = 0.192) or functional performance (pre = 9.00 [SD 1.56], post = 10.00 [SD 1.30], p = 0.060), and the pre- and post-intervention means remained similar, indicating the stability of these variables. The functional performance domains walking speed (pre = 3.85 [SD 0.37], post = 3.79 [SD 0.42], p = 0.586) and leg strength (pre = 2.08 [SD 1.12], post = 2.29 [SD 0.99], p = 0.838) did not change, although balance, specifically static balance, improved after the intervention (pre = 3.23 [SD 0.59], post = 3.86 [SD 0.53], p = 0.002).
CONCLUSIONS: The Amazonian dance intervention did not lead to significant changes in overall balance or functional performance, although the average values were maintained. There was improvement, however, in the static balance domain.

Brazilian Clinical Trials Registry (ReBEC) with the Universal Trial Number (UTN): U1111-1312-9102.

Keywords: dance; Amazon Region; Parkinson's disease; rehabilitation; Latin America.

OBJECTIVE: To describe the prevalence and factors associated with multimorbidity in a Brazilian sample of individuals aged 60 and over, according to their nutritional status (Body Mass Index-BMI).
METHODS: A cross-sectional study using the 2019 PNS database. All analyses were stratified by nutritional status (underweight; healthy weight; overweight). Multimorbidity prevalence was assessed for each stratum. Bivariate and multivariate Prevalence Ratios (PR), using Poisson regression, were calculated using a hierarchical model. Variables with a p-value of < 0.05 were considered significant.
RESULTS: The prevalence of multimorbidity was 58.1% and increased with increasing BMI. Higher prevalence was observed among women in the underweight (PR 1.44; 95%CI 1.26 – 1.64), healthy weight (PR 1.34; 95%CI 1.26 – 1.44), and overweight groups (PR 1.26; 95%CI 1.19 – 1.33). Individuals with poorer health status also had higher prevalence of the outcome (PR 2.08; 95%CI 1.76 – 2.46; PR 1.89; 95%CI 1.74 – 2.04; and PR 1.79; 95%CI 1.67 – 1.91, respectively). Higher formal education (PR 0.86; 95%CI 0.77 – 0.96), older age (PR 1.17; 95%CI 1.08 – 1.26), and smoking (PR 0.89; 95%CI 0.80 – 0.98) were associated with less multimorbidity, among those with healthy weight, while older age (PR 1.10; 95%CI 1.02 – 1.19) and smoking (PR 0.90; 95%CI 0.81 – 0.99) among those who were overweight.
CONCLUSIONS: More than half of older Brazilians live with multimorbidity and the frequency is higher among those with higher BMI. Obese older adults, females, and those whose self-assessment of their health is negative should be targeted for chronic disease prevention and health promotion campaigns.

Keywords: multimorbidity; nutritional status; aged; risk factors.

OBJECTIVE: To compare the characteristics and survival rates of older patients with sepsis with and without acute kidney injury (AKI).
METHODS: This retrospective cohort study included older patients (aged ≥ 60 years) admitted to the intensive care unit of a private hospital in Joinville, SC, Brazil, from December 2017 to August 2021, with a diagnosis of sepsis. Patients with AKI, with or without the need for dialysis, were compared with those without AKI regarding 30-day mortality. Multivariate Cox regression analysis was performed, adjusted for age (modeled using restricted cubic splines) and relevant clinical variables.
RESULTS: Of 690 patients, 49.4% had AKI, 14.2% of whom required hemodialysis. Patients with AKI requiring dialysis had higher creatinine and C-reactive protein levels at admission, higher SAPS-3, increased need for mechanical ventilation, and more frequent use of vasoactive drugs and corticosteroids. Among patients without AKI, 30-day survival was 73.8%, compared with 48.6% in patients with AKI not requiring dialysis and 56.8% in those requiring dialysis (log-rank p < 0.001). In multivariate analysis, AKI not requiring dialysis remained associated with increased risk of 30-day mortality (hazard ratio [HR] 2.33; 95% CI, 1.55–3.49; p < 0.001), whereas AKI requiring dialysis was not significantly associated (HR 1.32; 95% CI, 0.80–2.15; p = 0.275). Age did not change the effect of AKI on mortality.
CONCLUSION: In older patients with sepsis, AKI not requiring dialysis was associated with increased risk of mortality, whereas AKI requiring dialysis was not. This finding may reflect differences in clinical characteristics and disease severity between these patient subsets.

Keywords: acute kidney injury; intensive care units; sepsis; survival analysis; mortality; renal dialysis.

OBJECTIVE: To estimate the prevalence of multidimensional frailty (MF), identify associated factors, and characterize the clinical and functional profile of older adults with glaucoma who receive care from the Brazilian Unified Health System (SUS).
METHODS: Cross-sectional study of 202 older adults (age ≥ 60 years). We used the 10-minute Targeted Geriatric Assessment (10-TaGA) instrument to identify MF. Binary logistic regression (stepwise backward method) analyzed associations, at the 5% significance level.
RESULTS: The sample was predominantly female (64.9%) and "young-old" (53.0% of participants aged 60–69 years), with only 5.4% being octogenarians. The prevalence of MF was 6.4% (n = 13). The MF group had significantly higher rates of falls (84.6% vs. 32.8%; p < 0.001), polypharmacy (61.5% vs. 25.4%; p = 0.005), and decline in gait speed (30.8% vs. 1.6%; p < 0.001). On multivariable analysis, visual impairment (OR 6.11; 95% CI 1.64–22.8) and hearing impairment (OR 5.12; 95% CI 1.44–18.2) remained the main independent predictors of MF.
CONCLUSIONS: The prevalence of MF was lower than that reported in the literature, reflecting the younger profile of the sample and a probable healthy survivor effect bias. However, MF was strongly associated with cumulative sensory deficits. Integrating geriatric assessment into ophthalmic care is recommended to optimize clinical management and prevent functional decline.

Keywords: hearing; frailty; glaucoma; aged; sensory deprivation; primary health care.

OBJECTIVE: To compare records of the Multidimensional Assessment of the Older Adult (AMPI) intervention between Brazilian municipalities that participated and did not participate in in-person care quality improvement workshops and analyze the association between volume of AMPI records, frequency of AMPI application, and socioeconomic and demographic variables, including the Human Development Index (HDI).
METHODS: Cross-sectional study of primary health care managers and technicians affiliated with a university extension project. Municipalities that participated versus those that did not participate in the project workshops were compared using the Mann–Whitney U test and analysis of covariance (adjusted). Associations between number of AMPI records versus HDI and population factors were assessed using Spearman correlations and multiple linear regression, at a 5% significance level.
RESULTS: Of the 3011 municipalities included, 82.1% participated in the workshops. These municipalities accounted for a higher number of AMPI records (p < 0.001). However, the difference between participating and non-participating municipalities did not remain significant after adjusting for municipal characteristics. In the participating group, there was a weak positive correlation of the number of AMPI records with frequency of AMPI administration (r = 0.265), HDI (r = 0.172), and number of older adults as a share of the total population (r = 0.161). HDI was the only factor independently associated with number of records in the final model.
CONCLUSION: Municipalities which participated in the workshops showed a higher frequency of AMPI administration and a higher number of AMPI records. However, structural factors, such as the HDI, proved to be independent determinants. Therefore, quality improvement initiatives should take the local socioeconomic context into account.

Keywords: primary health care; health management; aged.

OBJECTIVE: To investigate changes in cognitive, neuropsychological, physical, and functional aspects, and quality of life in older adults with mild to moderate dementia over 1 year.
METHODS: This longitudinal study, approved by an Ethics Committee, included community-dwelling individuals aged ≥65 years with dementia classified as stage 1 or 2 according to the Clinical Dementia Rating. Personal, sociodemographic, clinical, and anthropometric data were collected. Cognitive and neuropsychological aspects were assessed using the Mini-Mental State Examination and the Cornell Scale for Depression in Dementia. Quality of life, strength, and functional status were assessed using the Quality of Life in Alzheimer’s Disease scale, handgrip strength test, gait speed, Katz Index, and Pfeffer Functional Activities Questionnaire. Assessments were conducted at baseline and after 1 year. Paired Student’s t-test and the McNemar test were used (p<0.05).
RESULTS: A total of 51 older adults, with a mean age of 81.1 (SD, 7.8) years, were included, of whom 47 were reassessed. No significant changes were observed in cognitive (p=0.139) or neuropsychological (p=0.306) aspects. Handgrip strength decreased significantly (p=0.022). No significant differences were found in gait speed (p=0.052), basic activities of daily living (p=0.791), or instrumental activities of daily living (p=0.084). A significant change was observed in caregiver-perceived quality of life (p=0.004).
CONCLUSION: We observed a decline in muscle strength and a negative impact on caregiver-perceived quality of life, highlighting the importance of integrated follow-up for both older adults with dementia and their caregivers.

Keywords: dementia; aging; functional status; quality of life.

OBJECTIVE: To investigate the association between self-perceived health (SPH), physical activity, and sedentary behavior among older Brazilians.
METHODS: Cross-sectional study using secondary data from the Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey – VIGITEL, year 2019. SPH was classified as good, fair, or poor. Older people who performed ≥ 150 minutes per week of moderate physical activity during leisure time and/or for commuting purposes were considered active. Sedentary behavior was defined as watching television for ≥ 4 hours per day. Analyses were conducted using multinomial logistic regression and adjusted for sociodemographic and health variables. SPH was considered the dependent variable, with a significance level of 5%.
RESULTS: Among the 22 898 participants, 69.8% were women, with a mean age of 70.9 years. Most participants rated their health as good (57.13%), 30.5% were physically active, and 31.2% were sedentary. Physically active older adults were 3.31 (95%CI 2.78-3.95) times more likely to report good SPH and 1.76 (95%CI 1.48-2.11) more likely to report fair SPH, with poor SPH as the reference category. Sedentary older adults were 1.09 (95%CI 1.02-1.17) times more likely to report fair SPH and 1.42 (95%CI 1.25-1.61) times more likely to report poor SPH, with good SPH as the reference category.
CONCLUSIONS: The results of this study suggest that physical activity is associated with better SPH, whereas sedentary behavior is associated with a more negative perception of health. These findings reinforce the importance of recommendations to promote physical activity and reduce sedentary behavior among older people.

Keywords: surveys and questionnaires; health services for the aged; diagnostic self evaluation; life style.

Rapid population aging has intensified the demand for long-term care, particularly in Brazil and Latin America. Long-term care facilities for older adults have become a strategic pillar of this debate, moving beyond historical stigma to assume a role as socio-healthcare facilities of fundamental importance in public policy planning and the protection of the rights of older adults. This viewpoint article synthesizes structural challenges and pathways for strengthening the sector in Brazil through a summary of key discussions presented during the "Overview of long-term care facilities for older adults in Brazil" session, held within the "Portraits of Brazil" panel at the XXIV Brazilian Congress of Geriatrics and Gerontology.

Keywords: aged; delivery of health care; homes for the aged; health policy.

This scoping review aimed to map recent scientific evidence on guidance related to aortic aneurysm directed at older adults in the hospital setting. The methodological recommendations of the Joanna Briggs Institute (JBI) were adopted, and the review was reported in accordance with PRISMA-ScR. We identified, selected, and synthesized studies published since 2020, considering care practices and management of older adults with aortic aneurysm in the hospital setting. A total of 34 publications were included in the final synthesis, most of which were retrospective cohort studies conducted in high-income countries. The findings were organized into thematic axes encompassing the importance of diagnosis, baseline geriatric assessment, modifiable risk factors amenable to perioperative care, socioemotional aspects, shared decision-making, treatment strategies, and treatment risks and outcomes. The analysis of the studies indicates that hospital care for older adults with aortic aneurysm is influenced by multiple clinical, functional, and psychosocial factors, in addition to reinforcing the need for structured educational guidance to improve care and support decision-making.

Registered in the Open Science Framework (OSF) (https://doi.org/10.17605/OSF.IO/BZMRU)

Keywords: aortic aneurysm; aged; hospital setting; Person-centered care.

BACKGROUND AND OBJECTIVE: Sexually transmitted infections are rarely considered as potential causes of dementia in the older population. This may be attributed to persistent misconceptions regarding sexuality in older adults, insufficient screening practices, and a general lack of information and preventive measures addressing this issue within this age group. This report describes a 63-year-old woman with rapidly progressive secondary dementia due to progressive multifocal leukoencephalopathy and neurosyphilis.
CASE DESCRIPTION: This report describes a 63-year-old woman with a 6-month history of rapidly progressive dementia, weight loss, and fever. She was admitted with apathy, tetraparesis, dysphagia, urinary incontinence, global aphasia, and oculomotor apraxia, with total dependence for basic activities of daily living. After hospital admission, laboratory work-up revealed HIV infection. Further investigation with cerebrospinal fluid analysis and magnetic resonance imaging led to a diagnosis of neurosyphilis and progressive multifocal leukoencephalopathy. Treatment was initiated with crystalline penicillin and antiretroviral therapy. After treatment, partial clinical improvement was observed, and CSF VDRL became nonreactive. The patient was discharged from the hospital with partial improvement in her gait and memory.
DISCUSSION: Rapidly progressive dementia (RPD) is a group of heterogeneous disorders characterized by rapidly deteriorating cognitive function that leads to dementia within a brief period progressing over weeks or months and often resulting in complete functional dependence within 1 to 2 years of symptom onset. Addressing secondary causes of dementia in older patients is essential because timely intervention may lead to partial or complete reversal of cognitive and functional impairments.

Keywords: neurosyphilis; dementia; progressive multifocal leukoencephalopathy; HIV; case report

BACKGROUND AND OBJECTIVE: Vascular cognitive disorder, a major cause of dementia and disability, arises from cerebrovascular pathology and often presents with a broad spectrum of cognitive and neuropsychiatric symptoms. Neuropsychiatric manifestations, such as mood disturbances, psychosis, and behavioral disinhibition, can precede cognitive decline, complicating early recognition and adversely affecting prognosis.
CASE DESCRIPTION: We report the case of an 81-year-old woman with vascular risk factors who presented with abrupt-onset behavioral changes, including elevated mood, disinhibition, erotomanic delusions, and second-person auditory-verbal hallucinations. Brain magnetic resonance imaging revealed extensive small vessel disease (Fazekas grade 3), multiple bilateral basal ganglia lacunes, and medial temporal atrophy. Neuropsychological assessment demonstrated impairment across the executive, memory, language, and visuospatial domains. A maniclike episode with psychotic features secondary to vascular cognitive disorder was diagnosed. Treatment with risperidone up to 3 mg/day led to substantial improvement, although mild residual disinhibition persisted.
DISCUSSION: This case fulfilled the diagnostic criteria for vascular cognitive disorder as defined by the International Society for Vascular Behavioral and Cognitive Disorders, with deficits across multiple cognitive domains and neuroimaging findings consistent with severe small vessel disease. Neuropsychiatric manifestations, including mania and psychosis, are encompassed within these criteria, reflecting the impact of cerebrovascular pathology on frontal-subcortical circuits and basal ganglia structures. Mania associated with vascular disease may emerge after a latent period, triggered by cumulative ischemic burden or age-related vulnerability. The persistence of behavioral disinhibition despite improvement with low-dose risperidone illustrates the therapeutic challenges of managing neuropsychiatric symptoms in vascular cognitive disorder. As no specific guidelines exist for mania in this context, treatment requires a cautious pharmacological approach complemented by non-pharmacological strategies. Longterm management should emphasize vascular risk control, caregiver education, and behavioral interventions to optimize outcomes and quality of life.

Keywords: dementia; mania; psychosis; vascular; case report.

BACKGROUD: Although physical exercise is an effective non-pharmacological strategy to reduce blood pressure (BP) in older adults, evidence remains limited regarding aquatic and communitybased training programs.
OBJECTIVE: This study evaluated the effects of an aquatic training program on BP and functional fitness in community-dwelling older adults.
METHODS: This single-arm trial enrolled participants in an aquatic exercise program offered by a university-affiliated public initiative. The intervention lasted eight months (two sessions per week, 45 min per session). Systolic BP (SBP), diastolic BP (DBP), and functional fitness (lower- and upper-body strength, lower- and upper-body flexibility, dynamic balance, and aerobic endurance) were assessed at baseline and post-intervention. Generalized estimating equations were used to compare outcomes between participants with and without pharmacological treatment for hypertension and between those engaged and not engaged in leisure-time physical activity (LPA).
RESULTS: SBP and DBP decreased after training (6/6 mm Hg, p < 0.001). Lower- and upper-body strength also improved (8% and 14%, p < 0.001), whereas no significant changes were observed in flexibility or aerobic endurance. Antihypertensive pharmacotherapy did not appear to influence BP reductions. Analysis by LPA status revealed that SBP decreased only among participants not previously engaged in LPA (-10 mm Hg, p = 0.02).
CONCLUSION: A low-frequency, community-based aquatic exercise program reduced BP and improved muscle strength in older adults, with greater BP reductions observed in those not engaged in LPA.

Keywords: healthy aging, hypertension, physical functional performance, senior centers, community-institutional relations.

OBJETIVE: To present the protocol for a single-blind, stratified randomized controlled trial designed to evaluate the effects of a multicomponent exercise program (MCEP), based on the ViviFrail^® model, on the intrinsic capacity and functional ability of socially vulnerable older adults, focusing on the physical domain of intrinsic capacity (body structure, body function, and movement-related activities).
METHODS: A total of 50 participants aged ≥ 60 years will be recruited from community-based organizations and randomly allocated (1:1) to either an intervention group (IG) or a control group (CG). The IG will complete a 24-week home-based MCEP, whereas the CG will participate in 12 weeks of structured social activities before crossing over to the same home-based MCEP for 12 weeks. Functional assessments will occur at baseline (week 0) and weeks 7, 14, 21, and 28 (post-intervention). The primary outcome will be the physical domain of intrinsic capacity, measured by the Short Physical Performance Battery (SPPB). Secondary outcomes will include gait speed, lower-extremity strength (Five-Times Sit-to-Stand Test), independence in activities of daily living (Barthel Index), self-rated health, and fall history. Data will be analyzed using generalized linear models for repeated measures under both intention-to-treat and per-protocol frameworks.
EXPECTED RESULTS: We hypothesize that participants in the IG will demonstrate clinically meaningful improvement in the physical domain of intrinsic capacity compared with those in the CG, including ≥ 1-point gains in SPPB scores.
RELEVANCE: Findings may inform scalable community-based strategies to enhance autonomy and equitable aging among socially vulnerable older adults.
Study protocol registered at ClinicalTrials.gov (NCT06271239) and at the Brazilian Registry of Clinical Trials (ReBEC) (RBR-2tq2jky:).

Keywords: multicomponent exercise; aging; functional status; randomized controlled trial; ViviFrail^®; Latin America.

OBJECTIVES: This protocol aims to explore the relationship between lifestyle and brain health biomarkers, assess the effects of a multifaceted intervention, and identify factors linked to brain resilience in middle-aged adults.
METHODS: Adults aged 40–59 years from Porto Alegre, RS, Brazil without neurodegenerative or severe psychiatric disorders will be included. The study consists of 3 phases: (1) online questionnaires assessing 7 brain health domains (general health, physical activity, cognition, social life, purpose, sleep, and nutrition); (2) clinical and functional assessments through biomarker collection, using instruments such as a P-WALK 2.0 baropodometric platform, a Cybex isokinetic dynamometer, an InBody 770, an OMRON sphygmomanometer, the Short Physical Performance Battery, and the Timed Up and Go test; (3) a 16-week randomized trial with 4 weekly sessions of strength and aerobic training. Post-intervention assessments will be conducted. Statistical analyses will include t-tests, ANOVA, regressions, and normality tests, using IBM SPSS Statistics, with significance set at p < 0.05. The study has been approved by the Institutional Research Ethics Committee (No. 7.323.434) and was funded by the National Council for Scientific and Technological Development (CNPq).
EXPECTED RESULTS: Brain health biomarkers should improve, especially in individuals with lower cognitive reserve, and we expect to identify modifiable factors associated with neuropsychological decline.
RELEVANCE: Midlife is a critical window for targeting brain health due to its relevance in preventing neurodegenerative diseases. This study seeks to support public health strategies promoting cognitive resilience.
REBEC trial registration number: RBR-6rrhxqg. UTRN: U1111-1323-9273.

Keywords: brain health; physical exercise; aging.

Exercise adherence has been considered a key determinant of clinical improvement in individuals with chronic pain. However, adherence rates are limited among older adults. This narrative review aimed to describe definitions of exercise adherence, explore associated barriers and facilitators, and detail multidimensional strategies to enhance adherence in older adults with chronic pain. Electronic searches were conducted in PubMed and Web of Science. Primary and secondary studies employing quantitative and qualitative design, published in English or Spanish, were included. Five categories of strategies to improve exercise adherence among older adults with chronic pain were identified: 1) person-centered: exploring and enhancing self-efficacy, motivation, and patient knowledge; 2) provider-centered: building a therapeutic alliance, promoting motivational interviewing, and tailoring exercise prescription; 3) context-centered: fostering social support and providing a pleasant clinical environment; 4) supervised exercise: being present and monitoring exercise, providing safety information, and providing immediate feedback; 5) unsupervised exercise: offering telerehabilitation sessions, supplementing with home visits, ensuring effective communication, assessing digital literacy, using reminders, demonstrating exercises in advance, prescribing simplified and individualized exercises, and providing written materials. Interventions to enhance exercise adherence should consider a personalized combination of strategies aligned with the individual's needs and the life context, so training functions as a safe learning environment enriched with positive affects.

Keywords: Exercise; Physical activity; Chronic pain; Older adults; Adherence.

Objective: To describe the geographic, methodological, and thematic characteristics of clinical trial protocols on exercise and physical activity interventions for older adults in Latin America and the Caribbean.
Methods: This cross-sectional descriptive study was based on an analysis of secondary records of a review of clinical trial protocols registered in the ClinicalTrials.gov database to identify protocols registered until June 2025. Eligible trials targeted adults ≥ 65 years of age, included exercise or physical activity as a primary intervention, and were conducted in Latin America and the Caribbean. The extracted data included country, intervention type, study design, recruitment status, outcomes, and funding source. Interventions were classified into 9 categories. Descriptive statistics were used to summarize the findings.
Results: A total of 185 protocols from 27 518 screened records met the inclusion criteria. Most were from Brazil (81.6%), followed by Chile (8.6%) and Mexico (5.4%). Muscle strengthening (19.7%) and multicomponent physical activity (18.1%) were the most frequent types, while 33.5% included non-conventional modalities, such as aquatic therapy, dance-based programs, Tai Chi, yoga, exergaming, and electrostimulation. Motor function was the most common primary outcome (39.5%). Most studies were completed (59.5%) and primarily funded by universities, with minimal involvement from industry (0.5%).
Conclusions: This is the first registry-based analysis of exercise and physical activity trial protocols for older adults in Latin America and the Caribbean, revealing a strong concentration in Brazil, a focus on muscle strengthening and multicomponent programs, and emerging innovative modalities. The limited outcome diversity and minimal private sector involvement highlight key gaps that should be addressed to strengthen the region’s research capacity and impact.

Keywords: age; elderly; exercise; physical activity; Latin America; healthy aging.

Objective: To investigate stair ascent and descent performance in adults and older adults, comparing locomotor performance between steps during the tasks.
Methods: This quasi-experimental cross-sectional study included older (n = 16) and younger adults (n=15). They ascended and descended a staircase of 4 steps at their usual velocity. Two GoPro cameras (sampling at 60 Hz) were used for kinematic analysis. Multivariate tests were performed to analyze locomotor pattern for spatiotemporal variables, such as toe clearance and horizontal distance variables related to the step. Our hypothesis was that the locomotor behavior of older adults would differ from that of young adults and that performance would be better while descending than ascending.
Results: The locomotor patterns did not differ significantly between adults and older adults during either stair ascent (p = 0.445) or descent (p = 0.322). During ascent, both groups exhibited significant decreases in step velocity and length (p ≤ 0.00) alongside increased step width (p = 0.003), with toe clearance for the dominant leg reaching its shortest point on the final step. Conversely, descent was characterized by significant increases in step velocity and length (p ≤ 0.001), though the risk associated with this task was specifically concentrated during transition moments without line-of-sight.
Conclusion: The locomotor pattern did not differ between groups. Locomotion is more challenging during ascent, while risk increases during transition moments in descent without line-of-sight. These adaptations in locomotor pattern may be related to higher risk during stair negotiation, which could result in training strategies for improving locomotor performance, transition tasks without line-of-sight, balance, and recovery during risky moments when ascending and descending stairs.

Keywords: locomotion, stair climbing; aging.

OBJECTIVE: To assess the effects of a structured multicomponent exercise program (VIVIFRAIL) on physical function, autonomy, and health-related quality of life in older adults aged 80 years and over.
METHODS: A randomized controlled trial was conducted with 158 participants (79 per group), with a median age of 85 years. The intervention group received individualized exercise prescriptions based on the VIVIFRAIL protocol. Follow-up lasted 24 months, with five assessment points using the Short Physical Performance Battery (SPPB), Barthel Index, Lawton-Brody Scale, and European Quality of Life Visual Analogue Scale (EQ-VAS).
RESULTS: No significant between-group differences were found in physical function (SPPB) or autonomy (Lawton-Brody), as both groups showed functional decline over time. However, subjective health perception (EQ-VAS) remained stable in the intervention group while decreasing significantly in the control group.
CONCLUSION: Although the intervention did not significantly modify the trajectory of physical decline, it had a positive effect on psychosocial well-being domains.

Clinical Trial Registration: Retrospectively registered at ClinicalTrials. gov, identifier NCT07447492.

Keywords: aged 80 and over, physical exercise, functional status, autonomy, quality of life.