title: Air Pollution and Successful Aging: Recent Evidence and New Perspectives.
abstract: Worldwide demographic changes occurring in a relatively short period have led to a growing interest in the determinants of aging "successfully" and how to promote a healthier old age. As environmental exposures such as ambient air pollution are believed to play a role in the process of aging, they might represent one of the pathways turning potential successful agers to unsuccessful agers. We aimed to critically review the current epidemiological evidence of the associations between chronic exposure to ambient air pollution and several key determinants of unsuccessful aging and to identify specific populations of unsuccessful agers that are potentially more vulnerable to air pollution's health effects.
  
  
  
  Epidemiologic evidence supports the association between air pollution and increased risk for several major chronic diseases, cognitive impairment, frailty, and decreased longevity-all important determinants of unsuccessful aging-as well as evidence for higher vulnerability among frail populations. However, several methodological shortcomings, including possible publication bias, lack of use of an adequate indicator of unsuccessful aging, limitations in exposure assessment, and residual confounding particularly due to socioeconomic status, hinder inference of causal relationship at this stage. Future studies should use constructs such as frailty index to estimate successful aging, as well as integrate time activity patterns into the exposure assessment metric. Additionally, studies in low- and middle-income countries are needed.
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel.
authors.forename: Gali
authors.initials: G
authors.lastname: Cohen
authors.affiliation: Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, 6997801, Israel. yarivg@post.tau.ac.il.
authors.forename: Yariv
authors.initials: Y
authors.lastname: Gerber
mesh_terms: D000375:Aging; D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000009:adverse effects*; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D006801:Humans; D052638:Particulate Matter / Q000032:analysis; D012307:Risk Factors
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter
keywords: Chronic exposure to air pollution; Frailty; Successful aging; Susceptible populations