Air Pollution and Performance-Based Physical Functioning in Dutch Older Adults

Abstract

Background/Aim: Functional limitations are a major cause for needing care and institutionalization among older adults. It has been suggested that exposure to air pollution is associated with increased functional limitations in older people. We assessed the association between air pollution and physical functioning in Dutch older adults. Methods: We analyzed data on performance-based and self-reported physical functioning for 1,735 participants of the Longitudinal Aging Study Amsterdam, who participated in at least one of three measurement cycles performed in 2005/2006, 2008/2009 and 2011/2012. Annual average outdoor air pollution concentrations [nitrogen dioxide (NO2), nitrogen oxides (NOx), particulate matter with diameters ≤ 2.5 µm (PM2.5), ≤ 10 µm (PM10), and 2.5-10 µm (PMcoarse), and PM2.5 absorbance] at the home address at the start of the first measurement cycle were estimated using land-use regression models. Analyses were performed using mixed models with random subject intercept accounting for correlation between repeated measurements within subjects, and adjusting for potential confounders. Results: Exposure to most air pollutants was associated with reduced performance-based physical functioning, e.g. an inter-quartile range increase in NO2 exposure was associated with a 0.35 (95 confidence interval: 0.20-0.51) lower performance test score, equivalent to the effect on performance of a 1-year increase in age. Exposure to air pollution was generally not associated with self-reported functional limitations, and not associated with the decline in performance-based physical functioning over the study period. Conclusions: This study suggests an adverse effect of exposure to air pollution on performance-based physical functioning of older adults in the Netherlands.