Narrative review reveals pathways including air pollution, physical exercise, and healthy diet that affect cognition in older adults, highlighting gaps in knowledge.
Cognition in older adults may be influenced by environmental factors; however, the pathways linking environmental exposures and cognition remain unclear. The aim of this narrative review is to synthesize evidence on the association between the environment and cognition in older adults, integrating biological, environmental, and behavioral elements. Systematic reviews and original studies addressing this topic were identified in Web of Science, PubMed, and Scopus. The primary neural processes associated with maintaining cognition during aging are neuronal plasticity and compensatory scaffolding. Participation in intellectually stimulating activities, physical exercise, and a healthy diet; mitigation of chronic stress; reduction in the severity of depressive symptoms; and buffering against the adverse effects of air pollution are proposed as plausible pathways that may mediate the relationship between neural processes and the environment. In this context, environmental factors that affect cognition can be classified at three levels: (i) micro-level (family and home): social interaction with family members and indoor pollution; (ii) meso-level (community and services): social interaction, land-use diversity, transportation systems, environmental design, and urban green spaces; and (iii) macro-level (society in general and public policies): social representations of old age and aging (positive aging vs. ageism) and public policies aimed at improving pathways related to cognitive maintenance. Overall, the environment may influence cognition in older adults; however, the available studies show methodological and conceptual heterogeneity, inconsistent findings, and important gaps in knowledge.
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Sánchez-Nieto et al. (2026) studied this question.
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