Rethinking biological resilience of older adults under climate change: an integrative perspective from planetary health and cultural ethics

Global climate change is an increasing challenge to healthy aging because extreme heat, air pollution, sleep disruption, and ecological instability can weaken physiological homeostasis in older adults. As aging reduces thermoregulatory, cardiovascular, immune, endocrine, and autonomic reserves, repeated climate stress may lead to delayed recovery and a biological resilience cascade that increases the risk of frailty, cognitive decline, cardiovascular events, hospitalization, and reduced healthspan. This Perspective proposes an integrative framework that situates biological resilience within psychosocial and cultural contexts. We argue that cultural ethics do not directly alter physiological biomarkers, but may shape upstream social and psychological conditions, including stress appraisal, help seeking, community care, adaptive behavior, and recovery after exposure. Drawing on planetary health and cultural ethics, we examine how Zhi Wei Bing, Ren, Yi, and Tian-Ren-He-Yi can inform climate adaptation for older adults. These concepts support preventive action, care for vulnerable groups, fair distribution of resources, resilience literacy, and ecological planning. By linking physiological mechanisms with psychosocial resources and cultural values, this article offers a hypothesis-generating framework for climate-resilient aging and for policies that protect vulnerable older adults in a warming world.