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Cumulative exposure to extreme heat and trajectories of cognitive decline among older adults in the USA
  1. Eun Young Choi1,
  2. Haena Lee2,
  3. Virginia W Chang1,3
  1. 1Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, USA
  2. 2Department of Sociology, Sungkyunkwan University, Seoul, Korea (the Republic of)
  3. 3Department of Population Health, Grossman School of Medicine, New York University, New York, New York, USA
  1. Correspondence to Dr Eun Young Choi, New York University, New York, New York, 10012, USA; ec4731{at}nyu.edu

Abstract

Background The projected increase in extreme heat days is a growing public health concern. While exposure to extreme heat has been shown to negatively affect mortality and physical health, very little is known about its long-term consequences for late-life cognitive function. We examined whether extreme heat exposure is associated with cognitive decline among older adults and whether this association differs by race/ethnicity and neighbourhood socioeconomic status.

Methods Data were drawn from seven waves of the Health and Retirement Study (2006–2018) merged with historical temperature data. We used growth curve models to assess the role of extreme heat exposure on trajectories of cognitive function among US adults aged 52 years and older.

Results We found that high exposure to extreme heat was associated with faster cognitive decline for blacks and residents of poor neighbourhoods, but not for whites, Hispanics or residents of wealthier neighbourhoods.

Conclusion Extreme heat exposure can disproportionately undermine cognitive health in later life for socially vulnerable populations. Our findings underscore the need for policy actions to identify and support high-risk communities for increasingly warming temperatures.

  • AGING
  • COGNITION
  • COHORT STUDIES
  • CLIMATE CHANGE

Data availability statement

Data are available in a public, open access repository. Data used in this study include publicly available and restricted data sets from the Health and Retirement Study (HRS), which is sponsored by the National Institute on Aging (NIA U01AG009740) and conducted by the University of Michigan website. The analytical datasets for this study incorporate multiple restricted data sources from the HRS. Due to privacy and confidentiality requirements, these datasets are not publicly available.

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Data availability statement

Data are available in a public, open access repository. Data used in this study include publicly available and restricted data sets from the Health and Retirement Study (HRS), which is sponsored by the National Institute on Aging (NIA U01AG009740) and conducted by the University of Michigan website. The analytical datasets for this study incorporate multiple restricted data sources from the HRS. Due to privacy and confidentiality requirements, these datasets are not publicly available.

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Footnotes

  • EYC and HL are joint first authors.

  • Contributors EC and HL conceptualised the study and designed the methodology. EC conducted data management and formal analysis. HL provided statistical supervision and conducted the main literature search. VWC supervised each part of the project, including study design, model specification and statistical analysis, and framed results. All authors contributed to the interpretation of data. EC drafted the manuscript, and HL and VWC contributed to the critical revision of the manuscript for important intellectual content. All authors reviewed and approved the final version of the manuscript for submission for publication. EC and HL are the guarantors.

  • Funding EC and VWC were supported by postdoctoral funding from New York University School of Global Public Health and HL was supported by the Faculty Start-up Fund from Sungkyunkwan University.

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  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.