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Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
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Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
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Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study

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Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study
Journal Article

Air Pollution Exposure and Muscle Mass and Strength Decline in Older Adults: Results From a Swedish Population–Based Study

2025
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Overview
Background Emerging evidence suggests that air quality may impact muscle health. However, most studies are limited by cross‐sectional designs or short follow‐ups. We assessed the association of long‐term exposure to ambient air pollutants with changes in muscle mass and strength in older adults. Methods We included 3249 participants from the SNAC‐K longitudinal study (mean age 74.3 years; 35.8% males). Muscle strength (measured through handgrip and chair stand tests), muscle mass (derived from calf circumference) and physical performance (assessed through walking speed at a usual pace) were assessed over a 12‐year period. Probable sarcopenia was defined as reduced muscle strength as per the EWGSOP2 criteria. Residential exposure to PM2.5, PM10 and nitrogen oxide (NOx) was estimated for the 5 years preceding baseline. Cox regressions and linear mixed models examined the association of air pollutant exposure with, respectively, probable sarcopenia and longitudinal changes in muscle parameters. Results Over 12 years, the cumulative incidence of probable sarcopenia increased with higher exposure (above vs. below the median values) to NOx (36% vs. 28%), PM2.5 (35% vs. 28%) and PM10 (35% vs. 28%). The association between air pollutant levels and the risk of probable sarcopenia was nonlinear (pnonlinearity = 0.002 for NOx, 0.001 for PM2.5 and 0.003 for PM10), with an increased risk showing a plateau at very high levels. Higher exposures were associated with an increased risk of developing probable sarcopenia, by 25% for NOx and PM2.5 (HR 95% CI: 1.07–1.47 for both) to 33% (HR 95% CI: 1.14–1.56) for PM10. Elevated pollutant exposure was associated with significantly greater annual declines in lower‐limb strength (chair stand test: 0.40–0.48 s) and walking speed (0.004 m/s). Conclusions Long‐term exposure to moderate levels of ambient air pollutants may increase the risk of probable sarcopenia and accelerate declines in lower‐limb strength and physical performance in older adults.