Older adults in some countries start losing their independence a decade earlier than others

Paying the bills, keeping track of the pills and getting to the store are what independent living comes down to. In every country, those jobs get harder with age. But the actual age this begins to become a problem isn’t the same everywhere.

Comparing more than 30,000 adults over 50, researchers found that Brazilians started having trouble with those tasks in their 60s, while Europeans mostly managed into their 70s. That decade can mean families and health systems have to step in earlier.

Vinicius Rosa Oliveira of the University of Vic in Spain led the analysis, with colleagues at Universidade Nove de Julho in São Paulo. Asked in an interview with Earth.com what a decade of difference looks like day to day, he put an age on it.

“A 62-year-old in Brazil might start struggling to manage their own medications, keep track of personal finances, shop for groceries, or navigate public transportation,” Oliveira said.

“In contrast, a 62-year-old in Europe typically manages these tasks with ease, only encountering similar functional hurdles around age 72 or older.”

Trouble with daily tasks starts in the 60s

Surveys like these exist because people are living longer than they used to. Brazil’s numbers came from ELSI-Brasil and Europe’s from SHARE, which runs in 28 countries and Israel.

Everyone in both surveys lives at home rather than in care, and after the team cleaned the data, 4,825 Brazilians and 25,978 Europeans were left.

Both surveys ask the same kind of yes-or-no question. Can you prepare a hot meal, take your own medicines, get across town on the bus?

In Brazil, adults aged 60 to 69 had about 40% higher odds of trouble with at least one of those jobs than the 50-somethings in the same survey. Europeans in that age band showed no such rise. The increase didn’t appear in Europeans until ages 70 to 79, when the odds ran about 60% higher.

The difference isn’t where older adults end up. By 80, both groups had four to five times the odds of the youngest adults in their own survey.

“This ten-year gap deprives individuals of a decade of healthy, autonomous retirement, placing a heavier reliance on family caregivers much earlier in life,” Oliveira said.

Doctors in Europe catch problems earlier

Oliveira told Earth.com that the difference “isn’t caused by biology alone; it is driven by lifetime structural inequality and environment.”

He gave three reasons. The first is what a doctor checks for.

“In Europe, routine health screenings catch conditions like high blood pressure, diabetes, vision problems, and hearing loss early, before they cause severe physical damage,” he said.

“In Brazil, many older adults face fragmented primary healthcare, meaning conditions are often diagnosed only after they have already caused lasting disability.”

Second is a lifetime of wear. Decades of low pay and hard physical work age a body faster, Oliveira said, and that leaves less in reserve when something finally goes wrong.

Third is the sidewalk. European cities generally have smoother pavement and public transit that works. Where that is missing, mild vision loss or a sore knee becomes a reason to stay home, which is how an older adult stops being socially engaged.

Poor memory raised the odds in both places

Memory was one risk that looked almost the same in both places. Rating your own memory as poor came with about 22% higher odds of trouble with daily tasks in Brazil, and 23% in Europe.

“Brain health is a universal cornerstone of daily independence, regardless of how rich or developed a country is,” Oliveira said.

Most other risks split country to country. Three or more chronic conditions came with 80% higher odds of trouble in Brazil, compared with 50% in Europe.

The senses split too. Poor hearing counted for more in Brazil, while in Europe weak eyesight was the one that came with higher risk, about a third more.

Brazilian men look healthier than they are

In Brazil, older men had half the odds of daily-living trouble that older women had. On paper, that reads like good news for men.

Oliveira said the answer is generational. “This is largely a cultural illusion because traditional gender roles mean men in older generations often didn’t perform household tasks like cooking or laundry in the first place, masking their actual functional decline.”

In Europe, where housework is shared more evenly, older men came out at higher risk than women for basic self-care such as bathing and dressing.

The strongest single risk factor anywhere in the study was incontinence, and it looked twice as strong in Europe. Europeans who used incontinence pads had about four times the odds of trouble with daily tasks. Brazilians who reported the problem had about twice.

“This doesn’t mean it is less common in Brazil; rather, strong cultural stigma in Latin America often leads to underreporting, leaving a major geriatric syndrome hidden and unaddressed in healthcare settings,” Oliveira said.

The study measured one moment in time

This analysis used one observation from each participant. That leaves the order of events open: whether hearing problems came first, or difficulty with daily activities did.

Almost all of it is self-reported. People rated their own hearing and eyesight, and said which conditions a doctor had named.

That second one matters, because a diagnosis needs a doctor and Brazilians reach one less often. So the Brazilian condition counts may be underestimated. The authors also note that men may play down what they can no longer do.

Timing counts too. Brazil’s survey ran through the harder phases of the pandemic, while Europe’s ran during a calmer stretch.

One measure existed on only one side. In Brazil, researchers timed how long each person took to walk about 10 feet (3 meters), and slower walkers had higher odds of trouble with basic self-care. Walking speed wasn’t available on the European side.

Brazil’s clinics would have to act first

Some of these risks can be treated or reduced. Hearing and eyesight can be be improved, and the authors also call for strength training and mobility programs.

Catching such problems early is the premise of the World Health Organization’s Integrated Care for Older People framework, which the researchers used to sort what they measured.

Asked by Earth.com what would move Brazil’s numbers, Oliveira described a change in what care is for.

“Closing this ten-year gap requires moving from reactive healthcare (treating illnesses after they cause disability) to proactive, integrated care that protects physical and mental capacity before it breaks down,” he said.

He wants that framework written into Brazil’s public health system, and care plans that handle several chronic conditions at once instead of one disease per appointment. Community health workers and family doctors, he said, need training to spot early functional loss and not only chronic disease.

Whether any of that could narrow the roughly ten-year gap is a question these surveys can’t answer. It would take a program running for years, and a count at the end of who is still doing their own shopping.

The full study was published in the journal PLOS One.

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