title: Environmental Pollutants, Limitations in Physical Functioning, and Frailty in Older Adults.
abstract: Frailty is an age-related syndrome characterized by reductions in strength, endurance, and physiologic function that increase an individual's vulnerability for developing dependence or death. Extensive research is currently being conducted to determine preventable risk factors and mechanistic pathways of frailty. This review summarizes the existing evidence on the potential associations between environmental pollutants, limitations in physical functioning, and frailty among older adults.
  
  
  
  We found only a few studies evaluating the association between specific environmental pollutants and frailty. Cross-sectional studies suggest an association between second-hand smoke and lead exposure with the prevalence of functional limitations and frailty in older adults; they also suggest a link between cobaltum exposure and walking problems. One longitudinal study found an increased risk of frailty after PM2.5 exposure among individuals hospitalized with a myocardial infarction, while another found an inverse association between cadmium and phthalate exposure and hand-grip strength. There is a clear need for more studies to assess the effects of environmental pollution on physical functioning decline, frailty development, and its progression. Environmental and geriatric epidemiologists should work together to address important research challenges.
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain. esthergge@gmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: García-Esquinas
authors.affiliation: Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid/ IdiPaz and CIBER of Epidemiology and Public Health (CIBERESP), Calle del Arzobispo Morcillo 4, 28029, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rodríguez-Artalejo
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D004785:Environmental Pollutants / Q000009:adverse effects*; D016330:Frail Elderly; D006801:Humans; D019216:Metals, Heavy / Q000009:adverse effects; D012307:Risk Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects
chemical_list: D004785:Environmental Pollutants; D019216:Metals, Heavy; D014028:Tobacco Smoke Pollution
keywords: Elderly; Environment; Frailty; Physical function; Pollution