How does pollution affect older people?

Pollution is a relevant issue, without a doubt. However, it sometimes seems to be understood as a kind of ideological position or as a kind of throwaway weapon, in which the most conservative sectors are opposed to recognising that it affects health or even that it exists. For example, in the United States last January, Trump eliminated environmental protection from streams, wetlands and groundwater. This was not an isolated regulation, but, with this one, the Trump administration completes a series of activities designed to put an end to the progress that the United States had made in environmental matters - it is important that we talk about the Trump administration' because, in the end, this is not just one individual who comes up with random ideas, but behind it there is a team that supports, that shares, that executes. In the time he has been in government, almost 100 environmental laws or climate change regulations have been repealed or reduced, concerning the protection of clean air, against chemical pollution, oil drilling (which produces as much economic benefit for a few as it does in other respects for many) and the protection of endangered species. There is nothing there.

We're not going to get our hands on Trump's head by criticizing him. In Spain there are also politicians who deny environmental pollution, either by denying it, or by saying that no one dies from it (we will see why this is a mistake) or in a factual way, by eliminating mechanisms to reduce environmental pollution (you will find the summary of this here, where we summarize these results). The truth is that yes, one does not die of love (said in his song Gianni Bella) but because of pollution, yes: the World Health Organization estimates that 4.2 million deaths per year worldwide are due to air pollution. This is related to the agglomeration in cities, which makes us need more transport (to get around, but also to get food, for example). The fact is that most modern cities have been designed more towards the need for transport than for their inhabitants, without regard to air quality concerns. In fact, 91% of the world's population lives in places that do not meet the air quality standards specified by the World Health Organization (WHO). Many cities have prioritized the use of motorized vehicles, which has had a significant negative impact on health and quality of life (discussed here). Amongst the older people affected by this use of space: children and the elderly, who are the least represented in space (not only socially, but also physically) and who are least thought of when intervening in urban space. 

Moreover, air pollution has been identified as the main health risk in the European Union. Not only is it carcinogenic (even when other variables are isolated), it reduces lung capacity, aggravates asthma and is associated with chronic lung diseases. It also causes infertility and type 2 diabetes in adults. It has also been linked to other diseases such as obesity, systemic inflammation, accelerated cellular ageing, dementia and Alzheimer's disease. It has other effects such as osteoporosis or even minor issues such as conjunctivitis. It affects different age groups differently. It is really negative among children, having shown lower intelligence, delays in psychomotor development and affects their memory terribly. Between pregnancies it also has very negative consequences, reducing the transport of oxygen and nutrients to the developing fetus, in addition to having effects on the speed of delivery (Mendola, P. et al. here).

The other age group that is most affected is the elderly. It not only shortens their life, but makes it worse. There is strong evidence of an association between short-term exposure to air pollutants and increased respiratory disease among older people. This is important, because we are talking here about the short term: it is not a risk that is "deferred" and potential in time. It is a risk that threatens here and now. Chronic exposure to high levels of air pollution has been linked to the incidence of chronic obstructive pulmonary disease, chronic bronchitis, asthma and pulmonary emphysema. There is also a growing body of evidence suggesting that a variety of adverse effects on respiratory function are associated with long-term exposure to ambient air pollution.

Above all, however, it functions as an aggravating factor for pre-existing conditions. And we do not know more because (this will not surprise you) less effort has been put into analysing the effects of pollution on older people. It has recently been found that it does affect the brain in the same way that Alzheimer's does. Yes, it causes less mental acuity, according to a study led by Diana Younan. As she and other researchers point out, long-term exposure to air pollution is associated with lower scores on mental acuity tests. One reason may be that air pollution causes changes in the structure of the brain that resemble those produced by Alzheimer's disease. In their study, conducted in the United States over 11 years (how wonderful to have the funding to be able to do longitudinal research) with 998 participating women between the ages of 73 and 87, they found that the greater the exposure to certain air pollutants, the lower their scores on cognitive tests. We are talking about healthy women without dementia and the referred pollutant was PM 2.5. These are very small particles, which easily enter the lungs and the bloodstream and, as a colleague at MIT told me, can more or less literally pierce our lungs. Come on, when we breathe in pollution, our brain atrophies in the same way that Alzheimer's would. We're looking for a cure for Alzheimer's; why not go for urban policies that reduce air pollution? Not only is prevention better than cure. It's usually cheaper too. As the icing on the cake, reducing pollution (and traffic) would have positive effects on the inclusion of children and older people in social space. Sounds good, doesn't it?