Conte Keivabu Risto, Zagheni Emilio, Fink Anne
Digital and Computational Demography Lab, Max Planck Institute for Demographic Research, Rostock, Germany.
German Center for Neurodegenerative Diseases, Bonn, Germany.
J Gerontol A Biol Sci Med Sci. 2025 Mar 7;80(4). doi: 10.1093/gerona/glae292.
Extreme temperatures are associated with negative health outcomes, in particular for older adults with pre-existing conditions. While climate change is expected to increase exposure to temperature levels that are detrimental to health, little is known about how dementia shapes vulnerability to extreme temperatures.
We leveraged repeated quarterly individual-level health claims from 2004 to 2019 on 250 000 individuals in Germany aged 50 years and above with information on key neurodegenerative diseases such as dementia. We linked data on the location of residence of these individuals with high-resolution gridded meteorological data. In our empirical analysis, we applied an individual-level fixed effects model to estimate how temperature affects the single patient's probability of hospitalization and death, adjusted for seasonality and comorbidities.
Our findings reveal that heat and cold exposure increases the risk of death. Conversely, the association between extreme temperatures and hospital admissions is more nuanced showing an increase only with cold exposure. Stratifying the analysis by individuals affected by dementia, we observe heat to increase mortality only for individuals with dementia and cold to determine an 8 times larger impact on them and a larger increase in hospitalization. Also, we observe individuals aged above 80 and with dementia to be the most at risk of death with exposure to cold and in particular heat.
Our study contributes to the growing body of evidence on the health impacts of climate change and emphasizes the need for targeted strategies to protect vulnerable groups, particularly patients with dementia, from adverse temperature effects.
极端温度与负面健康结果相关，尤其是对患有基础疾病的老年人而言。虽然预计气候变化会增加人们暴露于对健康有害的温度水平的机会，但对于痴呆症如何影响对极端温度的易感性却知之甚少。
我们利用了2004年至2019年德国25万名50岁及以上个体的季度个人层面健康索赔数据，这些数据包含痴呆症等关键神经退行性疾病的信息。我们将这些个体的居住地点数据与高分辨率网格气象数据相链接。在实证分析中，我们应用个体层面固定效应模型来估计温度如何影响单个患者的住院和死亡概率，并对季节性和合并症进行了调整。
我们的研究结果表明，暴露于高温和低温会增加死亡风险。相反，极端温度与住院之间的关联更为微妙，仅在暴露于低温时才会增加。按受痴呆症影响的个体进行分层分析，我们观察到高温仅会增加痴呆症患者的死亡率，而低温对他们的影响要大8倍，住院率增加也更大。此外，我们观察到80岁及以上且患有痴呆症的个体在暴露于寒冷尤其是高温时死亡风险最高。
我们的研究为气候变化对健康影响的越来越多的证据做出了贡献，并强调需要制定有针对性的策略来保护弱势群体，特别是痴呆症患者免受不利温度影响。
