# The Impact of Temperature and Pollution on Mortality, Morbidity, and Health Care Cost Among the Elderly

> **NIH NIH R01** · NATIONAL BUREAU OF ECONOMIC RESEARCH · 2020 · $376,508

## Abstract

OTHER PROJECT INFORMATION – Project Summary/Abstract
Determinants of Vulnerability to Environmental Stress Among the Elderly ADRD Population
As individuals live longer, healthier lives, the number of people living with, and dying from, Alzheimer’s Disease
(AD) has risen. AD prevalence and mortality are expected to continue to rise in the future. However, while AD
is fatal and individuals living with AD have high mortality rates, their immediate cause of death is usually
respiratory disease or ischemic heart disease rather than dementia. Consequently, improving the health and
quality of life of people living with ADRD depends on understanding their vulnerability to these diseases, and
how these conditions interact with their dementia.
Our proposed study focuses on the determinants of health and mortality among those in the Medicare
population who have been identified as living with ADRD. Because cardiovascular and respiratory diseases
have been identified as frequent causes of death among the ADRD population, we focus on an environmental
stressor that increases the likelihood of death due to cardiovascular and respiratory causes: acute exposure to
air pollution. Using a large dataset of Medicare beneficiaries and machine-learning techniques applied to
quasi-random variation in pollution exposure generated by changes in local wind direction, we find that acute
exposure to air pollution increases mortality risk for only about one quarter of the elderly. While individuals
living with ADRD are much more likely to be in this vulnerable group than the typical Medicare beneficiary, we
find that acute air pollution exposure does not increase mortality risk for a large fraction (44%) of Medicare
beneficiaries living with ADRD.
In this study, we will apply machine learning and “big data” techniques to Medicare administrative data, local
characteristics, and atmospheric variables in order to understand why some individuals living with ADRD suffer
harm from the increased cardiovascular and respiratory stress induced by air pollution exposure while others
do not. These factors, once identified and verified in continuing research, will provide guidance that can
improve the health and quality of life of individuals living with ADRD by better directing resources to those most
in need and guiding interventions aimed at reducing vulnerability to these and other hazards.
As part of the project, we will develop a publicly available database that provides the following data at the ZIP
code level: ADRD prevalence, vulnerability to air pollution exposure among the ADRD population, and ZIP
code level characteristics that have been shown to affect vulnerability. Other researchers can then use this
data for any other study seeking to understand the effects of geographically defined factors or policies on the
ADRD population.

## Key facts

- **NIH application ID:** 10123225
- **Project number:** 3R01AG053350-05S1
- **Recipient organization:** NATIONAL BUREAU OF ECONOMIC RESEARCH
- **Principal Investigator:** NOLAN H MILLER
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $376,508
- **Award type:** 3
- **Project period:** 2016-09-01 → 2022-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10123225

## Citation

> US National Institutes of Health, RePORTER application 10123225, The Impact of Temperature and Pollution on Mortality, Morbidity, and Health Care Cost Among the Elderly (3R01AG053350-05S1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10123225. Licensed CC0.

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