6. Biblioteca del Centro Centroamericano de Población
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El Centro Centroamericano de Población (CCP) es un centro de investigaciones de la Universidad de Costa Rica, establecido inicialmente en 1993 como un Programa adscrito a la Escuela de Estadística.
El CCP tiene un área de acción multidisciplinaria en la investigación, capacitación y diseminación de información en población con un ámbito Centroamericano.
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De la Fuente de la Hispanidad 100 este, 100 norte y 100 este.
San Pedro de Montes de Oca.
Centro Centroamericano de Población,
Universidad de Costa Rica
San José 2060, Costa Rica.
Correo electrónico: ccp@ucr.ac.cr
Teléfonos:
(506) 2511-1452,
(506) 2511-1450,
(506) 2511-1716 (Biblioteca)
San Pedro de Montes de Oca.
Centro Centroamericano de Población,
Universidad de Costa Rica
San José 2060, Costa Rica.
Correo electrónico: ccp@ucr.ac.cr
Teléfonos:
(506) 2511-1452,
(506) 2511-1450,
(506) 2511-1716 (Biblioteca)
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Item Social connections, leukocyte telomere length, and all-cause mortality in older adults from Costa Rica : the Costa Rican longevity and healthy aging study (CRELES)(Journal of Aging and Health, DOI: 10.1177/08982643251313923, 2025) Gan, Danting; Baylin, Ana; Peterson, Karen E.; Rosero Bixby, Luis; Ruiz Narváez, Edward A.Objectives: To examine the association of social connections with blood leukocyte telomere length (LTL) and all-cause mortality in older Costa Ricans. Methods: Utilizing data from the Costa Rican Longevity and Healthy Aging Study (CRELES), a prospective cohort of 2827 individuals aged 60 and above followed since 2004, we constructed a Social Network Index (SNI) based on marital status, household size, interaction with non-cohabitating adult children, and church attendance. We used linear regression to assess SNI’s association with baseline LTL (N = 1113), and Cox proportional-hazard models to examine SNI’s relationship with all-cause mortality (N = 2735). Results: Higher SNI levels were associated with longer telomeres and decreased all-cause mortality during follow-up. Being married and regular church attendance were associated with 23% and 24% reductions of the all-cause mortality, respectively. Discussion: These findings underscore the importance of social engagement in promoting longevity among older Costa Ricans, suggesting broader implications for aging populations globally.Item The COVID-19 pandemic and fertility decline in Costa Rica: A deep plunge in the first pandemic month, a decelerated decline, and a baby bust due to fleeing migrants(International Journal of Population Studies, 2024) Rosero Bixby, LuisUsing microdata from the administrative birth registry maintained by the electoral authority of Costa Rica, this paper aims to address the knowledge gap concerning childbearing during the COVID-19 pandemic in the context of rapid fertility decline since before the pandemic, as compared to the scenario in the highly developed countries. Monthly fertility rates for the period between 2018 and 2022 were estimated. The outcome of interest was a year-on-year change in these rates. The major findings of this study are as follows: (i) A short-lived baby bust in the first full month of the pandemic that is similar to falls observed in other countries (the year-on-year decrease of fertility in January 2021 was as high as 24% for some groups); (ii) a pandemic-associated deceleration in the fertility decline, which could be interpreted as a baby boom if the counterfactual were a continuation of the recent pre-pandemic declining trend; (iii) hints of a baby boom later in the pandemic in communities with low socioeconomic status, and especially, in families with several children, which could come from unwanted pregnancies; and (iv) an anomalous drop in births from foreign-born mothers delivered during the first 9 months of the pandemic, which probably stemmed from pandemic-motivated migration out of the country. The fertility plunge in January 2021 seems to be a response to the hardships caused by pandemic mitigation measures in April 2020, as well as by the uncertainties and fears concerning COVID-19, rather than the response to the physiological harm of the disease itself. The native-born Costa Ricans saw some of the lowest total birth rates in the world during the pandemic: 1.14 and 1.13 births per woman in 2021 and 2022, respectively. These rates would have been even lower if the sharp birth decline observed before the pandemic had continued during the two pandemic years under studyItem Socioeconomic inequalities in national transfers accounts in Ecuador 2006 and 2011: did a new socialist government make a difference?(The Journal of the Economics of Ageing, vol.27, 2024) Rosero Bixby, LuisLatin America is the least egalitarian region in the world. A neo-socialist government in Ecuador prioritized the reduction of socioeconomic status (SES) inequalities. The generational economy is a framework to understand the economic lifecycle and to link demographic change with people’s well-being. This article aims to uncover SES-driven inequalities in the generational economy of Ecuador: did public transfers modify them from 2006 to 2011? National transfer accounts (NTA) were disaggregated by SES quartiles, which were defined by the highest level of education attainment in each household. The accounts within SES quartiles were estimated using standard NTA methods. A pseudo-Gini coefficient summarized SES-driven inequalities by age and generational account. This secondary analysis was based on existing micro databases from the Ecuadorian NTA. Results: National averages do not represent well the generational economy of the low-SES population. The usual gradient of higher economic figures in higher SES strata shows up in almost all NTAs with the notable exceptions of reversal (progressive) gradients in conditional public cash transfers to low-SES households and public education at the elementary school level. Retirement pensions are extremely regressive public transfers, benefiting mostly high-SES strata. Conclusions: Population aging might worsen the high levels of inequality already existing in Ecuador and Latin America. Some progressive public policies worked well to reduce inequality in Ecuador. Contribution: This article demonstrates the importance of uncovering SES-driven inequalities existing in NTAs and their change through the lifecycle. It also identifies public policies that ameliorated inequality as well as public transfers that are regressive.Item Traditional rural dietary pattern and all-cause mortality in a prospective cohort study of elderly Costa Ricans: the Costa Rican Longevity and Healthy Aging Study (CRELES)(The American Journal of Clinical Nutrition, 2024) Zhang, Yundan; Cortés Ortiz, Mónica V.; Leung, Cindy W.; Baylin, Ana; Rosero Bixby, Luis; Ruiz Narváez, Edward A.Costa Rica, as many other Latin American countries, is experiencing a fast demographic aging. It is estimated that by 2030, 18.5% of the population, or almost 1 of every 5 Costa Ricans, will be 60 y or older, compared with 7.9% or 1 of every 13 Costa Ricans in 1999 [1]. As the population ages, chronic health conditions such as cardiovascular diseases (CVDs) and neurodegenerative disorders are expected to increase in prevalence posing growing challenges to the health of the Costa Rican population. With the demographic shift toward an aging population, there is an urgent need to study determinants of longevity and healthy aging. Diet—as part of a healthy lifestyle—is a key modifiable factor that may help to minimize the burden of age-related health conditions. Beans are a major source of protein and fiber in Costa Rican adults and part of traditional diets in most Latin American countries. High bean consumption has been found associated with a protective cardiometabolic prolife such as low total cholesterol and LDL cholesterol [2,3]. In the Costa Rican population specifically, intake of beans has been associated with lower risk of nonfatal myocardial infarction in middle-aged adults [4]. We recently reported that a traditional Costa Rican rural dietary pattern, rich in beans and rice, was associated with longer leukocyte telomeres—a marker of biologic aging—in Costa Rican adults 60 y and older [5]. However, no studies have examined whether adherence to a traditional diet in elderly Costa Ricans may also be associated with lower mortality. Because of the nutrition transition (i.e., a shift from traditional diets to an increased consumption of processed foods highs in sugars, fats, and salt) experienced by Costa Rica in the last decades [4,6,7], it is essential to evaluate the potential impact of traditional diets on promoting healthy aging and longevity within an aging population. In this study, we assessed the association between a traditional rural dietary pattern, as well as their major food components beans and rice, and all-cause mortality among elderly Costa Ricans aged 60 y and older at baseline. We hypothesized that higher scores on the traditional dietary pattern are associated with lower all-cause mortality in elderly Costa Ricans. We also assessed whether additional dietary patterns may be associated with all-cause mortality. We used longitudinal and nationally representative data from the Costa Rican Longevity and Healthy Aging Study (CRELES).Item Centenarian clocks: epigenetic clocks for validating claims of exceptional longevity(SPRINGER LINK, vol. 45, 2023) Dec, Eric; Clement, James; Cheng, Kaiyang; Church, George M.; Fossel, Michael B.; Rehkopf, David H.; Rosero Bixby, Luis; Kobor, Michael S.; Lin, David TS.; Lu, Ake T.; Fei, Zhe; Guo, Wei; Chew, Yap Ching; Yang, Xiaojing; Dwi Putra, Sulistyo E.; Reiner, Alex P.; Correa, Adolfo; Vilalta, Adrian; Pirazzini, Chiara; Passarino, Giuseppe; Monti, Daniela; Arosio, Beatrice; Garagnani, Paolo; Franceschi, Claudio; Horvath, SteveClaims surrounding exceptional longevity are sometimes disputed or dismissed for lack of credible evidence. Here, we present three DNA methylation-based age estimators (epigenetic clocks) for verifying age claims of centenarians. The three centenarian clocks were developed based on n = 7039 blood and saliva samples from individuals older than 40, including n = 184 samples from centenarians, 122 samples from semi-supercentenarians (aged 105 +), and 25 samples from supercentenarians (aged 110 +). The oldest individual was 115 years old. Our most accurate centenarian clock resulted from applying a neural network model to a training set composed of individuals older than 40. An epigenome- wide association study of age in different age groups revealed that age effects in young individuals (age < 40) are correlated (r = 0.55) with age effects in old individuals (age > 90). We present a chromatin state analysis of age effects in centenarians. The centenarian clocks are expected to be useful for validating claims surrounding exceptional old age.Item The vanishing advantage of longevity in Nicoya, Costa Rica: A cohort shif(Demographic Research, vol.49 (27, 2023) Rosero Bixby, LuisBACKGROUND The Nicoya region in Costa Rica has been identified as one of a handful of hotspots of extreme longevity. The evidence supporting this status comes mostly from observing the 1990 and 2000 decades and cohorts born before 1930. OBJECTIVE To determine how the longevity advantage of older men in Nicoya has progressed in the period 1990 to 2020 and in cohorts born from 1900 to 1950. METHODS Remaining length of life and adult mortality were estimated using new public administrative records from the electoral system and a Gompertz regression model. A new nationwide survival-time database of 550,000 adult Costa Ricans who were alive at any point during 1990–2020 was put together. RESULTS The longevity advantage of Nicoya is disappearing in a trend driven mostly by cohort effects. While Nicoyan males born in 1905 had 33% lower adult mortality rates than other Costa Ricans, those born in 1945 had 10% higher rates. The original geographic hotspot of low elderly mortality, coined the Nicoya blue zone, has decreased to a small area south of the peninsula around the corridor from Hojancha inland to the beach town of Sámara. However, Nicoyans born before 1930 who are still alive continue to show exceptionally high longevity. CONCLUSIONS Surviving Nicoyan males born before 1930 are exceptional human beings living longer than expected lives. Not so for more recent cohorts. The window of opportunity to meet and study pre-1930 individuals is closing.Item La tasa de fecundidad de 1,3 hijos por mujer de 2021 y 2022 de cara al futuro: ¿Ultrabaja fecundidad o posposición de la maternidad? Implicaciones demográficas(CONARE, PEN, 2023) Rosero Bixby, LuisCosta Rica llegó en 2021 y 2022 a una tasa global de fecundidad (TGF) de 1,3 hijos, nivel conocido como de “ultrabaja fecundidad”. Este ultrabajo valor podría ser un espejismo causado por posposición de nacimientos entre las personas jóvenes. La TGF de cohorte –que está libre de perturbaciones por posposición– fue 2,4 hijos por mujer para la cohorte que completó la fecundidad en 2022 (nacidas en 1972). Se simulan dos escenarios futuros de esta tasa: (1) que las niñas nacidas en el 2000 lleguen al fin de su periodo reproductivo (en el 2050) con una familia de 1,3 hijos en promedio –ultrabaja fecundidad– o (2) con dos hijos –escenario de posposición. La población total del país llegaría a un máximo 5,3 o 5,6 millones con estos escenarios, y el declive subsiguiente la llevaría a 4,5 o 5,4 millones en 2075. Una robusta inmigración podría elevar en 700 mil habitantes la población de 2075. La población en edad escolar caerá fuertemente en los dos escenarios, desde el máximo de un millón en 2002 a tan solo 320 mil educandos con familias de 1,3 hijos o 600 mil con familias de dos hijos. La población en edad retiro (que es independiente de la fecundidad en los próximos 65 años) aumentará vigorosamente de 510 mil actuales a 1,9 millones en 2075, en contraste con la población en edades activas que disminuirá desde un máximo de 3,6 millones en 2038 a 2,2 o 2,6 millones en 2075, haciendo que el cociente de sustento demográfico de las pensiones caiga en ambos escenarios, de siete actual a cerca de un trabajador por pensionado en 2075, sin que la migración pueda tener un impacto relevante. No parece existir respuesta demográfica realista que evite el colapso del sistema de pensiones de reparto.Item Epigenome-Wide Association Study and Epigenetic Age Acceleration Associated with Cigarette Smoking among Costa Rican Adults(Scientific Reports, Vol. 12 Núm, 2022) Cárdenas, Andrés; Ecker, Simone; Fadadu, Raj P.; Huen, Karen; Orozco, Allan; McEwen, Lisa M.; Engelbrecht, Hannah Ruth; Gladish, Nicole; Kobor, Michael S.; Rosero Bixby, Luis; Dow, William H.; Rehkopf, David H.Smoking-associated DNA methylation (DNAm) signatures are reproducible among studies of mostly European descent, with mixed evidence if smoking accelerates epigenetic aging and its relationship to longevity. We evaluated smoking-associated DNAm signatures in the Costa Rican Study on Longevity and Healthy Aging (CRELES), including participants from the high longevity region of Nicoya. We measured genome-wide DNAm in leukocytes, tested Epigenetic Age Acceleration (EAA) from five clocks and estimates of telomere length (DNAmTL), and examined effect modification by the high longevity region. 489 participants had a mean (SD) age of 79.4 (10.8) years, and 18% were from Nicoya. Overall, 7.6% reported currently smoking, 35% were former smokers, and 57.4% never smoked. 46 CpGs and five regions (e.g. AHRR, SCARNA6/SNORD39, SNORA20, and F2RL3) were differentially methylated for current smokers. Former smokers had increased Horvath’s EAA (1.69-years; 95% CI 0.72, 2.67), Hannum’s EAA (0.77-years; 95% CI 0.01, 1.52), GrimAge (2.34-years; 95% CI1.66, 3.02), extrinsic EAA (1.27-years; 95% CI 0.34, 2.21), intrinsic EAA (1.03-years; 95% CI 0.12, 1.94) and shorter DNAmTL (− 0.04-kb; 95% CI − 0.08, − 0.01) relative to non-smokers. There was no evidence of effect modification among residents of Nicoya. Our findings recapitulate previously reported and novel smoking-associated DNAm changes in a Latino cohort.Item Derivation, internal validation, and recalibration of a cardiovascular risk score for Latin America and the Caribbean (Globorisk-LAC): A pooled analysis of cohort studies(The Lancet Regional Health - Americas, 9, 2022) Stern, Dalia; Hambleton, Ian R.; Lotufo, Paulo Andrade; Di Cesare, Mariachiara; Hennis, Anselm; Ferreccio, Catterina; Irazola, Vilma; Perel, Pablo; Gregg, Edward W.; Aguilar Salinas, Carlos Alberto; Álvarez Vaz, Ramón; Amadio, Marselle Bevilacqua; Baccino, Cecilia; Bambs S., Claudia; Bastos, João Luiz Dornelles; Beckles, Gloria; Bernabé Ortiz, Antonio; Bernardo, Carla; Bloch, Katia Vergetti; Blümel, Juan Enrique; Boggia, José G.; Borges, Pollyana Kássia de Oliveira; Bravo, Miguel; Brenes Camacho, Gilbert; Carbajal, Horacio A.; Casas Vásquez, Paola; Castillo Rascón, María Susana; Ceballos, Blanca H.; Colpani, Verônica; Cooper, Jackie A.; Cortés, Sandra; Cortés Valencia, Adrián; de Sá Cunha, Roberto; d'Orsi, Eleonora; Dow, William H.; Espeche, Walter G.; Fuchs, Flavio Danni; Pereira Costa Fuchs, Sandra Cristina; Godoy Agostinho Gimeno, Suely; Gómez Velasco, Donaji Verónica; González Chica, David Alejandro; González Villalpando, Clicerio; González Villalpando, María Elena; Grazioli, Gonzalo; Guerra, Ricardo Oliveira; Gutierrez, Laura E.; Herkenhoff Vieira, Fernando Luiz; Horimoto, Andrea Roseli Vancan Russo; Huidobro Muñoz, Laura Andrea; Koch, Elard S.; Lajous Loaeza, Martin; Furtado de Lima e Costa, Maria Fernanda; López Ridaura, Ruy; Campos Cavalcanti Maciel, Álvaro; Maestre, Gladys Elena; Manrique Espinoza, Betty Soledad; Marques, Larissa Pruner; Melgarejo Arias, Jesus David; Mena Camaré, Luis Javier; Mill, Jose Gerardo; Moreira, Leila Beltrami; Muñoz Velandia, Oscar Mauricio; Ono, Lariane Mortean; Oppermann, Karen; Ortiz Saavedra, Pedro José; de Paiva, Karina Mary; Viana Peixoto, Sérgio William; da Costa Pereira, Alexandre; Peres, Karen G.; de Anselmo Peres, Marco Aurelio; Ramírez Palacios, Paula; Rech, Cassiano Ricardo; Rivera Paredez, Berenice; Rodríguez Guerrero, Nohora Inés; Rojas Martínez, Maria Rosalba; Rosero Bixby, Luis; Rubinstein, Adolfo; Ruiz Morales, Álvaro de Jesus; Salazar, Martin R.; Salinas Rodríguez, Aarón; Nájera Salmerón, Jorge Alberto; Sánchez, Ramón Augusto; de Souza e Silva, Nelson Albuquerque; Nogueira da Silva, Thiago Luiz; Smeeth, Liam; Spritzer, Poli Mara; Tartaglione, Fiorella; Tartaglione, Jorge; Tello Rodríguez, Tania; Velázquez Cruz, Rafael; Cohorts Consortium of Latin America and the Caribbean (CC-LAC); Carrillo Larco, Rodrigo Martín; Miranda Montero, Juan J.; Ezzati, Majid; Danaei, GoodarzBackground: Risk stratification is a cornerstone of cardiovascular disease (CVD) prevention and a main strategy proposed to achieve global goals of reducing premature CVD deaths. There are no cardiovascular risk scores based on data from Latin America and the Caribbean (LAC) and it is unknown how well risk scores based on European and North American cohorts represent true risk among LAC populations. Methods: We developed a CVD (including coronary heart disease and stroke) risk score for fatal/non-fatal events using pooled data from 9 prospective cohorts with 21,378 participants and 1,202 events. We developed laboratory based (systolic blood pressure, total cholesterol, diabetes, and smoking), and office-based (body mass index replaced total cholesterol and diabetes) models. We used Cox proportional hazards and held back a subset of participants to internally validate our models by estimating Harrell’s C-statistic and calibration slopes. Findings: The C-statistic for the laboratory-based model was 72% (70−74%), the calibration slope was 0.994 (0.934−1.055) among men and 0.852 (0.761−0.942) among women; for the office-based model the C-statistic was 71% (69−72%) and the calibration slope was 1.028 (0.980−1.076) among men and 0.811 (0.663−0.958) among women. In the pooled sample, using a 20% risk threshold, the laboratory-based model had sensitivity of 21.9% and specificity of 94.2%. Lowering the threshold to 10% increased sensitivity to 52.3% and reduced specificity to 78.7%. Interpretation: The cardiovascular risk score herein developed had adequate discrimination and calibration. The Globorisk-LAC would be more appropriate for LAC than the current global or regional risk scores. This work provides a tool to strengthen risk-based cardiovascular prevention in LAC.Item The Effectiveness of Pfizer-BioNTech and Oxford-AstraZeneca Vaccines to Prevent Severe COVID-19 in Costa Rica: Nationwide, Ecological Study of Hospitalization Prevalence(JMIR Public Health and Surveillance, vol.8(5), 2022) Rosero Bixby, LuisBackground: The Costa Rican COVID-19 vaccination program has used Pfizer-BioNTech and Oxford-AstraZeneca vaccines. Real-world estimates of the effectiveness of these vaccines to prevent hospitalizations range from 90%-98% for two doses and from 70%-91% for a single dose. Almost all of these estimates predate the Delta variant. Objective: The aim of this study is to estimate the dose-dependent effectiveness of COVID-19 vaccines to prevent severe illness in real-world conditions in Costa Rica, after the Delta variant became dominant. Methods: This observational study is a secondary analysis of hospitalization prevalence. The sample is all 3.67 million adult residents living in Costa Rica by mid-2021. The study is based on public aggregated data of 5978 COVID-19–related hospital records from September 14, 2021, to October 20, 2021, and 6.1 million vaccination doses administered to determine hospitalization prevalence by dose-specific vaccination status. The intervention retrospectively evaluated is vaccination with Pfizer-BioNTech (78%) and Oxford-AstraZeneca (22%). The main outcome studied is being hospitalized. Results: Vaccine effectiveness against hospitalization (VEH) was estimated as 93.4% (95% CI 93.0-93.9) for complete vaccination and 76.7% (95% CI 75.0-78.3) for single-dose vaccination among adults of all ages. VEH was lower and more uncertain among older adults aged ≥58 years: 92% (95% CI 91%-93%) for those who had received full vaccination and 64% (95% CI 58%-69%) for those who had received partial vaccination. Single-dose VEH declined over time during the study period, especially in the older age group. Estimates were sensitive to possible errors in the population count used to determine the residual number of unvaccinated people when vaccine coverage is high. Conclusions: The Costa Rican COVID-19 vaccination program that administered Pfizer-BioNTech and Oxford-AstraZeneca vaccines seems to be highly effective at preventing COVID-19–related hospitalization after the Delta variant became dominant. Even a single dose seems to provide some degree of protection, which is good news for people whose second dose of the Pfizer-BioNTech vaccine was postponed several weeks to more rapidly increase the number of people vaccinated with a first dose. Timely monitoring of vaccine effectiveness is important to detect eventual failures and motivate the public to get vaccinated by providing information regarding the effectiveness of the vaccines.