The interplay between climate change and ageing: A systematic review of health indicators

As climate change phenomena become more intense and frequent, population acclimatiza- tion is necessary to survive [65]. However, human adaptation and temperature tolerance have limitations, especially in the more vulnerable groups. Hence, it is crucial to prioritize the implementation of strategies aimed at minimizing exposure to the effects of climate change [65]. Afar the impact on the quality of human life and risk of death, climate change also leads to a high economic burden. Although most available economic evidence on health costs related to the impact of climate change has gaps or limitations, it is clear that implementing health protection measures will yield economic benefits through reduced expenditure on future health treatments [66]. Our review had several strengths. To our knowledge, to date, this is the first systematic review that explores all potential global climate change scenarios and their corresponding health outcomes in individuals aged 65 or older. Also, the literature search was run in three different databases. However, some limitations must be noted. The time frame used can be a limitation in our study. It’s possible that this limited period might not fully capture certain health outcomes more prevalent in older adults. By excluding studies that included mixed pop- ulations, to minimize the extent of our analysis, some important health outcomes with more predominance in older adults were not mentioned. Also, only English language studies were considered. Finally, most of the articles included are from developed countries, which may

underestimate the burden of climate change. Since developing countries may experience more intense phenomena. Thus, the articles presented in this review may not be a true representa- tion of all valid articles–selection bias. Conclusions This systematic review examined 19 studies that sought to identify health indicators illustrating the influence of climate change on the health and well-being of older adults. The review found various morbidity outcomes, including diseases related to the cardiovascular, respiratory, and renal systems, mental health conditions, and physical injuries. Additionally, the review explored all-cause mortality as well as cause-specific mortality. Given the unpredictable nature of climate change’s impact on human health, adjusting to its fluctuations poses significant challenges. We hope with this review to provide additional evidence on health indicators in older adults to enable the implementation of more robust pre- vention and intervention strategies and care-seeking behaviours to promote better adaptation and mitigation of the effects of climate change. However, studies that relate climate change to older adults and health are still scarce, and the 19 studies we considered eligible mostly crossed hospital and meteorological databases. This may lead to an incomplete representation of the population and health outcomes and may not provide a comprehensive understanding of the broader population, limiting the gen- eralizability of the results to other populations or regions. In some studies, a lack of a control

population was also observed. To overcome these limitations, it would be beneficial the pro- duction of studies that combine data from multiple sources to provide an accurate assessment of the health impacts of climate change on older adults. Supporting information S1 Checklist. PRISMA 2020 checklist. (DOC) PLOS ONE Climate change, ageing and health PLOS ONE | https://doi.org/10.1371/journal.pone.0297116 April 24, 2024 13 / 17