Evidence map›Paper›PMID 40391839›Full record

SynthesisAge and ageing2025

A systematic review and meta-analysis of air pollution and increased risk of frailty.

Zahra Jafari, Melissa Andrew, Kenneth Rockwood

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Age and ageing, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. When air gets heavy: joint PMFrontiers in public health · 2026
    Article
  6. Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Zahra JafariSchool of Communication Sciences and Disorders (SCSD), Dalhousie University, Halifax, Nova Scotia, Canada.ORCID 0000-0002-0485-2003
Melissa AndrewDivision of Geriatric Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.ORCID 0000-0001-7514-8972
Kenneth RockwoodDivision of Geriatric Medicine, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEnvironmental air pollution is increasingly recognised as a potential contributor to frailty. This systematic review and meta-analysis aimed to synthesise existing evidence on the associations between environmental air pollution and frailty in middle-aged and older adults, providing insights into the impact of air pollution on public health.

methodsThe systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement 2020. Four electronic databases were searched without restrictions on language, publication status, or year of publication.

resultsOf the 145 publications identified through the systematic search, 18 were included. Meta-analyses indicated a 19% increased risk of frailty due to air pollution (fine particulate matter ≤2.5 microns) [n = 9 studies; pooled odds ratio (OR) 1.19; 95% confidence interval (CI) 1.10-1.27], a 28% increase with exposure to household solid fuels (n = 4 studies; OR 1.28; 95% CI 1.16-1.40) and a 59% increase due to exposure to secondhand smoke (n = 3 studies; OR 1.59; 95% CI 0.46-2.72). Except for the meta-analysis on air pollution, no heterogeneity or risk of publication bias was observed amongst the included studies. The Joanna Briggs Institute checklist confirmed high methodological quality across all included studies.

conclusionsEnvironmental exposures, including air pollution, the use of unclean household fuels and exposure to secondhand smoke, significantly increase the risk of frailty. These findings underscore the urgent need to raise awareness and establish effective public health strategies to reduce these environmental risks and associated frailty, particularly in light of population ageing.

Indexed as

Air PollutionEnvironmental ExposureFrailtyAgedAged, 80 and overFemaleFrail ElderlyHumansMaleMiddle AgedRisk AssessmentRisk Factorsair pollutionfrailtyhousehold fuelsolder adultsolder peoplesecondhand smokesystematic review

Identifiers

PMID40391839
PMCPMC12159732

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.