Dementia and all-cause mortality in older adults: Findings from the ELSI-Brazil study

Introduction: Although nearly two-thirds of all dementia cases occur in low- and middle-income countries, evidence on dementia-related mortality in these settings remains scarce. Methods: We analyzed 5249 participants aged ≥60 years from the Brazilian Longitudinal Study of Aging (ELSI-Brazil). Dementia was defined using an algorithm or self-reported diagnosis. Mortality rates were estimated by dementia status, sex, and age. Among individuals with dementia (n = 392), multivariate Cox models assessed predictors of all-cause mortality. Results: Mortality was higher in individuals with dementia even after adjusting for age and sex (hazard ratio: 2.65; 95% confidence interval: 2.08 to 3.39). Among people with dementia, male sex, higher education, poorer functional status, and lower cognitive performance increased mortality risk, while having a partner was protective. Discussion: Dementia markedly increased mortality risk. Functional impairment, cognitive decline, social support, and schooling were key determinants of survival, emphasizing the importance of targeted, context-specific strategies to improve outcomes for people living with dementia.