Particulate air pollution, exceptional aging, and rates of centenarians: a nationwide analysis of the United States, 1980-2010

BACKGROUND: Exceptional aging, defined as reaching age 85 years, shows geographic inequalities that may depend on local environmental conditions. Links between particulate pollution--a wellrecognized environmental risk factor--and exceptional aging have not been investigated. OBJECTIVES: We conducted a nationwide analysis of ~28 million adults in 3,034 United States counties to determine whether local [PM.sub.2.5] levels (particulate matter < 2.5 pm in aerodynamic diameter) affected the probability of becoming 85-to 94-year-olds or centenarians (100- to 104-year-olds) in 2010 for individuals who were 55-64 or 70-74 years old, respectively, in 1980. METHODS: We used population-weighted regression models including county-level [PM.sub.2.5] from hybrid land-use regression and geostatistical interpolation, smoking, obesity, sociodemographic, and age-specific migration variables. RESULTS: On average, 2,295 and 71.4 per 10,000 of the 55- to 64- and 70- to 74-year-olds in 1980, respectively, remained in the 85- to 94- and 100- to 104-year-old population in 2010. An interquartile range (4.19 µg/[m.sup.3]) increase in [PM.sub.2.5] was associated with 93.7 fewer 85- to 94-yearolds (p < 0.001) and 3.5 fewer centenarians (p < 0.05). These associations were nearly linear, were stable to model specification, and were detectable below the annual [PM.sub.2.5] national standard. Exceptional aging was strongly associated with smoking, with an interquartile range (4.77%) increase in population who smoked associated with 181.9 fewer 85- to 94-year-olds (p < 0.001) and 6.4 fewer centenarians (p < 0.001). Exceptional aging was also associated with obesity rates and median income. CONCLUSIONS: Communities with the most exceptional aging have low ambient air pollution and low rates of smoking, poverty, and obesity. Improvements in these determinants may contribute to increasing exceptional aging. http://dx.doi.org/10.1289/EHP197
Introduction Recent declines in mortality have resulted in a worldwide increase in exceptional aging, defined as reaching age 85 years or older [National Institute on Aging (NIA) 2013]. Persons ≥ [...]