Leprosy is an infectious disease with high potential for disability and significant impact on public health in Brazil. In the elderly population, it is particularly concerning due to a higher risk of complications and more severe disease. The states of Rio Grande do Sul (RS), Minas Gerais (MG), and Rio de Janeiro (RJ), which have the largest elderly populations in Brazil, were selected as the basis for analyzing leprosy behavior in this age group. The study aimed to analyze the epidemiological profile of leprosy among older adults, focusing on clinical form, presence of leprosy reactions, and degree of disability at diagnosis between 2014 and 2024. Observational, descriptive, and retrospective study based on secondary data from the Notifiable Diseases Information System (SINAN) from 2014 to 2024 for the states of MG, RS, and RJ. Age group, clinical form at diagnosis, disability assessment at notification, and reaction episodes were analyzed. A total of 8,612 cases were identified (MG = 54%, RJ = 39.6%, RS = 6.4%). The 60–69 age group accounted for 59.9% of notifications, followed by 70–79 years (30.7%) and ≥80 years (9.3%). Multibacillary forms predominated, particularly the borderline form ‒ 49.3% in MG, 36.4% in RJ, and 42.9% in RS ‒ and the lepromatous form ‒ 23.8%, 26.7%, and 25%, respectively. Grade II disability was recorded in 25.3% of cases in Rio Grande do Sul, 19.8% in Minas Gerais, and 14.5% in Rio de Janeiro. Regarding leprosy reactions, MG had 53.7% with missing information; when reactions were reported, RJ showed the highest proportion (21.9%), followed by MG (9.5%) and RS (12.7%). Leprosy, especially in Minas Gerais, accounted for most cases. Multibacillary forms predominated, particularly the borderline clinical form, with a high proportion of grade II disability, indicating late diagnosis and risk of complications. Significant underreporting of leprosy reactions was observed, mainly in Minas Gerais, indicating failures in data completion. A discrepancy was noted in Rio Grande do Sul, which, despite having a large elderly population, showed low occurrence of leprosy, suggesting underdiagnosis or lower disease circulation. The findings highlight the need for early diagnosis, professional training, improved notification, and deeper investigation of regional differences in leprosy among older adults.
Lira et al. (Sun,) studied this question.