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

Abstract

Background:

Functional limitations are a major cause for needing care and institutionalization among older adults. Exposure to air pollution has been suggested to be associated with increased functional limitations in older people.

Objective:

Our objective was to assess the association between air pollution and physical functioning in Dutch older adults.

Methods:

We analyzed data on performance-based (walking speed, ability to rise from a chair, putting on and taking off a cardigan, balance test) and self-reported physical functioning for 1,762 participants of the Longitudinal Aging Study Amsterdam, who participated in measurement cycles performed in 2005/2006, 2008/2009, and 2011/2012. Annual average outdoor air pollution concentrations [nitrogen dioxide ( ${\text{NO}}_2$ ), nitrogen oxides ( ${\text{NO}}_{\mathrm{x}}$ ), particulate matter with diameters $\le 2.5\mathrm{\mu }\mathrm{m}$ ( ${\mathrm{PM}}_{2.5}$ ), $\le 10\mathrm{\mu }\mathrm{m}$ ( ${\mathrm{PM}}_{10}$ ), and $2.5–10\mathrm{\mu }\mathrm{m}$ ( ${\mathrm{PM}}_{\text{coarse}}$ ), and ${\mathrm{PM}}_{2.5}$ 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 participant intercepts adjusting for potential confounders.

Results:

Exposure to most air pollutants was associated with reduced performance-based physical functioning; for example, an interquartile range increase in ${\text{NO}}_2$ exposure was associated with a 0.22 (95% confidence interval: 0.03, 0.42) lower performance test score in fully adjusted models, equivalent to the difference in performance score between participants who differed by 9 mo in age. Exposure to air pollution was generally not statistically significantly associated with self-reported functional limitations, and not associated with a faster decline in performance-based physical functioning over the study period.

Conclusion:

This study suggests that exposure to air pollution may adversely affect physical performance of older adults in the Netherlands. https://doi.org/10.1289/EHP2239