ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2026
Heterogeneous associations of cumulative heat exposure with cognitive decline among older Japanese adults.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionWe investigated heterogeneity in the association between cumulative heat exposure and cognitive decline among older Japanese adults.
methodsWe analyzed 33,877 adults aged ≥ 65 years from a nationwide cohort (2010-2023) linked with long-term care insurance data. Cumulative heat exposure was indexed using population-weighted wet-bulb globe temperature. Generalized random forests estimated the average and conditional treatment effects. Heterogeneity was decomposed using permutation importance, excess CATE analysis, and UpSet plot analyses.
resultsDuring a 12-year follow-up, 25.3% developed cognitive decline. Heat exposure increased incidence by 12.17 cases per 1000 person-years (95% confidence interval [CI]: 2.54-21.62). Vulnerability profiles differed by age: among adults aged 65-74 years, multidimensional social and health constraints predominated; among those aged ≥ 75 years, functional decline and relational depletion dominated. DISCUSSION: Age-specific vulnerability profiles provide a foundation for precision public health: multidomain interventions for adults aged 65-74 years and proactive social outreach for those aged ≥ 75 years.
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