Advancing age and mortality due to pollution exposure: a comprehensive review

The global aging population has been increasingly vulnerable to environmental stressors, particularly air pollution. Advancing age is associated with physiological declines and a higher prevalence of chronic diseases, heightening susceptibility to pollution-related health effects. This review explores the relationship between advancing age and mortality/morbidity due to pollution exposure, consolidating evidence on how pollution exacerbates health risks in elderly populations. Based on the epidemiological evidence, this comprehensive literature review evaluates the interaction between aging, pollution exposure, and the biological mechanisms that make older adults more vulnerable to pollution-related mortality/morbidity. Google Scholar, PubMed, and Scopus were systematically searched to identify relevant studies, including cohort studies, meta-analyses, and reviews. Studies were selected based on their focus on air pollution, aging populations, and mortality. Inclusion criteria included peer-reviewed articles addressing pollution-related health outcomes in older adults, specifically emphasizing cardiovascular, respiratory, and neurological impacts. Aging amplifies the harmful effects of air pollution through mechanisms like oxidative stress, impaired immune responses, and chronic inflammation. Elderly populations are disproportionately affected by pollutants such as particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone. Mortality, specifically due to cardiovascular, respiratory, and neurodegenerative diseases, is significantly higher in older adults exposed to long-term pollution. Air pollution, as an effect modifier, intensifies the health risks associated with aging. Older adults face heightened mortality risks due to pollution, demanding public health strategies to prioritize pollution reduction and protective interventions at individual and population levels.