Global, Regional, And National Burden of Environmental Heat and Cold Exposure in Adults Aged 55 Years and Older From 1990 To 2021 (January 2026)-Global, Regional, And National Burden of Environmental Heat and Cold Exposure in Adults Aged 55 Years and Older From 1990 To 2021

Global, Regional, And National Burden of Environmental Heat and Cold Exposure in Adults Aged 55 Years and Older From 1990 To 2021

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This study by Li et al. (2025) presents a comprehensive analysis of the global, regional, and national burden of environmental heat and cold exposure (EHCE) on adults aged 55 and older from 1990 to 2021, using data from the Global Burden of Disease Study 2021. The research examines incidence, prevalence, mortality, and disability-adjusted life years (DALYs) associated with EHCE, exploring trends by sex, age, and sociodemographic index (SDI).<br /><br />Key findings show a general global decline in EHCE-related incidence, prevalence, mortality, and DALYs among older adults over the study period. The incidence decreased from 40.49 to 25.68 per 100,000, with males consistently exhibiting higher rates than females, though the gender gap narrowed. The most pronounced decreases were observed in the youngest older adults (aged 55-59) and in countries with high-middle SDI levels. Conversely, high-SDI countries experienced stagnation or even increases in EHCE-related mortality and DALYs, and the high-income Asia Pacific region uniquely showed rising EHCE incidence and mortality, attributed to factors including rapid urbanization, population aging, and reliance on controlled indoor environments that may reduce physiological resilience to temperature extremes.<br /><br />Regionally, East Asia and Latin America displayed significant reductions in EHCE burden, while the high-income Asia Pacific faced increasing rates. Nationally, Afghanistan showed the fastest reduction in incidence, while Turkmenistan experienced the greatest increase. China and Japan, both aging societies, demonstrated contrasting patterns: China saw declines due to adaptation measures and health system improvements, Japan an increase likely related to advanced aging and urban heat effects.<br /><br />The study highlights the vulnerability of older adults to temperature extremes due to physiological declines and chronic conditions, exacerbated by climate change’s impact on extreme weather frequency. It emphasizes the need for targeted, region-specific climate adaptation strategies integrating health, demographic, and socioeconomic factors to protect aging populations worldwide.<br /><br />Limitations include reliance on modeled GBD data with variable quality, uncertain COVID-19 pandemic impacts, potential selective survival biases in oldest age groups, and insufficient consideration of synergistic factors like air pollution. The authors advocate for strengthened climate-health-aging policies, improved public health infrastructure, and integration of temperature-related risks in chronic disease management to enhance global resilience against EHCE.

Keywords

environmental heat and cold exposure

older adults

global burden of disease

incidence and prevalence

mortality and DALYs

sociodemographic index

climate adaptation strategies

temperature extremes

aging populations

regional trends