{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T14:31:04Z","timestamp":1786113064351,"version":"build-2736575974"},"reference-count":35,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Introduction<\/jats:title>\n Global aging patterns are highly heterogeneous, especially in diverse socioeconomic contexts.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n We aimed to analyze the determinants of functional performance within the WHO\u2019s Integrated Care for Older People (ICOPE) framework.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Functional performance was evaluated using basic and instrumental activities of daily living (BADL\/IADL) from ELSI-Brasil and SHARE cohorts. Sociodemographic characteristics and the clinical domains of intrinsic capacity (mobility, vitality, cognition, psychological, and sensory functions) were also assessed.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The final sample consisted of 4,825 participants from ELSI-Brasil and 25,978 from SHARE. Functional risks diverged significantly based on intrinsic capacity domains: i) mobility: handgrip strength was a stronger protective factor in Europe, while the walking speed was a unique BADL risk factor in Brazil (OR 1.16); ii) vitality: weight loss showed a significant BADL risk for Europeans (OR 1.18); iii) cognition: low self-perceived memory showed similar risk for IADL across both cohorts (SHARE OR 1.23 vs. ELSI-Brasil OR 1.22); iv) psychological: depression posed a higher independent risk in Europe (OR 1.67\u20131.71) than in Brazil (OR 1.26\u20131.53), while poor self-rated health reflected higher risk in the Brazilian context (BADL OR 2.72 vs. 2.07 in Europe); v) sensory function: hearing impairment was a stronger IADL risk in Brazil (OR 1.27), while vision was significant only in Europe (OR 1.32).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Functional decline begins a decade earlier in Brazil than in Europe, reflecting socioeconomic disparities across intrinsic capacity domains. ICOPE strategies should be tailored to each societal context to promote equitable healthy aging.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0353750","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T17:21:11Z","timestamp":1785950471000},"page":"e0353750","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A decade of difference: cross-continental patterns of functional performance in Brazil and Europe within the WHO ICOPE framework"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9681-7036","authenticated-orcid":true,"given":"Vinicius Rosa","family":"Oliveira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o Ant\u00f4nio Rodrigues","family":"Praia J\u00fanior","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo Dantas","family":"Dematte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Alberto","family":"Sanches","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe Farah Pinheiro","family":"Rodrigues","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduard","family":"Minobes-Molina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Librantz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciana Maria Malos\u00e1","family":"Sampaio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"pone.0353750.ref001","unstructured":"World Health Organization. Active Ageing: A Policy Framework. 2002. https:\/\/iris.who.int\/items\/46476232-b305-47b4-ab28-e3931607c70c"},{"key":"pone.0353750.ref002","unstructured":"World Health Organization. World report on ageing and health. 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Integrated Care for Older People: Guidelines on community-level interventions to manage declines in intrinsic capacity. 2017. https:\/\/www.who.int\/publications\/i\/item\/9789241550109"},{"key":"pone.0353750.ref006","doi-asserted-by":"crossref","first-page":"80","DOI":"10.2307\/2626958","article-title":"Social conditions as fundamental causes of disease","author":"BG Link","year":"1995","journal-title":"J Health Soc Behav"},{"key":"pone.0353750.ref007","doi-asserted-by":"crossref","first-page":"102239","DOI":"10.1016\/j.arr.2024.102239","article-title":"Social determinants of intrinsic capacity: A systematic review of observational studies","volume":"95","author":"Z-T Huang","year":"2024","journal-title":"Ageing Res Rev"},{"issue":"9","key":"pone.0353750.ref008","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1038\/s43587-024-00684-2","article-title":"Real-life intrinsic capacity screening data from the ICOPE-Care program","volume":"4","author":"BP De Souto Barreto","year":"2024","journal-title":"Nat Aging"},{"key":"pone.0353750.ref009","first-page":"23","article-title":"Long-term care systems in comparative perspective: Care needs, informal and formal coverage, and social impacts in European countries","author":"F Carrera","year":"2013","journal-title":"Reforms in long-term care policies in Europe. New York, NY: Springer New York"},{"key":"pone.0353750.ref010","article-title":"Macroeconomic effects of the demographic transition in Brazil","author":"RD Brito","year":"2023","journal-title":"N\/A"},{"key":"pone.0353750.ref011","doi-asserted-by":"crossref","DOI":"10.4103\/sja.SJA_543_18","article-title":"The STROBE guidelines","volume":"13","author":"S Cuschieri","year":"2019","journal-title":"Saudi J Anaesth"},{"issue":"1","key":"pone.0353750.ref012","article-title":"Cohort Profile: The Brazilian Longitudinal Study of Ageing (ELSI-Brazil)","volume":"52","author":"MF Lima-Costa","year":"2023","journal-title":"Int J Epidemiol"},{"key":"pone.0353750.ref013","article-title":"Survey of Health, Ageing and Retirement in Europe (SHARE) Wave 9","author":"SHARE-ERIC","year":"2024"},{"key":"pone.0353750.ref014","volume-title":"CRISP-DM 1.0: Step-by-step Data Mining Guide","author":"P Chapman","year":"2000"},{"issue":"4","key":"pone.0353750.ref015","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1093\/ije\/dyt088","article-title":"Data Resource Profile: the Survey of Health, Ageing and Retirement in Europe (SHARE)","volume":"42","author":"A B\u00f6rsch-Supan","year":"2013","journal-title":"Int J Epidemiol"},{"key":"pone.0353750.ref016","article-title":"Physical activity and functional preservation in older adults with hip osteoarthritis: A comparative analysis of age cohorts in the SHARE study. 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Gutierrez-Robledo","year":"2023","journal-title":"J Nutr Health Aging"},{"key":"pone.0353750.ref020","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1186\/1477-7525-12-88","article-title":"Gender differences in healthy life expectancy among Brazilian elderly","volume":"12","author":"AP Belon","year":"2014","journal-title":"Health Qual Life Outcomes"},{"issue":"6","key":"pone.0353750.ref021","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s11154-022-09737-6","article-title":"Mortality and morbidity in ageing men: Biology, Lifestyle and Environment","volume":"23","author":"E Zhao","year":"2022","journal-title":"Rev Endocr Metab Disord"},{"issue":"4","key":"pone.0353750.ref022","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1093\/geronb\/gbw209","article-title":"Gendered Expectations Distort Male-Female Differences in Instrumental Activities of Daily Living in Later Adulthood","volume":"74","author":"CM Sheehan","year":"2019","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"issue":"6","key":"pone.0353750.ref023","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1111\/jan.15183","article-title":"Perceptions and help-seeking behaviours among community-dwelling older people with urinary incontinence: A systematic integrative review","volume":"78","author":"F Yan","year":"2022","journal-title":"J Adv Nurs"},{"key":"pone.0353750.ref024","article-title":"Primary care and healthcare utilization among older Brazilians (ELSI-Brazil)","author":"J Macinko","year":"2018","journal-title":"Rev Saude Publica"},{"issue":"11","key":"pone.0353750.ref025","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0294935","article-title":"Functional limitation in the older Brazilian adults: Association with multimorbidity and socioeconomic conditions","volume":"18","author":"MM Lopes Vieira","year":"2023","journal-title":"PLoS 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