Heterogeneous associations of cumulative heat exposure with cognitive decline among older Japanese adults.

Authors

Hiroyuki Hikichi, Kai Chen, Nobutoshi Nawa, Ayako Morita, Yusuke Matsuyama

Published in

Alzheimer's & dementia : the journal of the Alzheimer's Association. Volume 22. Issue 7. Pages e71670.

Abstract

We investigated heterogeneity in the association between cumulative heat exposure and cognitive decline among older Japanese adults.
We 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.
During 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.
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.

PMID:
42449183
Bibliographic data and abstract were imported from PubMed on 15 Jul 2026.

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