Adaptations to Climate Change-Related Environmental Phenomena to Achieve Physical Activity Recommendations for Adults Aged 65 and Older

BACKGROUND: Regular physical activity promotes health, quality of life, and functional independence in older adults. However, climate change is leading to increasing environmental stressors such as heat, air pollution, and pollen exposure, which increase health risks and hinder adherence to physical activity recommendations. Older adults, particularly those with cardiovascular or respiratory conditions and pollen allergies, are especially affected. The aim of this project was to develop evidence-based recommendations to safely enable physical activity under climatically challenging conditions. METHODS: The recommendations were developed through a three-step process: (1) a systematic online search of relevant guidelines, professional and governmental publications, and information from patient organisations; (2) an interdisciplinary expert workshop to refine and adapt recommendations for the target group; (3) a modified Delphi process with experts to finalise recommendations through multiple feedback rounds. RESULTS: A total of 54 relevant articles published by 24 institutions were identified and compiled into a preliminary catalogue. The developed recommendations for heat, air pollution, and pollen exposure include: adaptation of activity according to timing and location (using climatically favourable time windows and indoor spaces), selection of appropriate intensity and types of exercise, breaks, hydration, sun protection, and self-monitoring of physiological warning signs. For individuals with pollen allergies, indoor activities, low-pollen locations, and the use of pollen forecasts are recommended. The recommendations provide practical guidance to maintain physical activity despite adverse environmental conditions. CONCLUSIONS: An evidence-based, systematic approach to complement physical activity recommendations with climate-change-related environmental stressors is feasible and necessary. Older adults can remain active, reduce health risks, and preserve independence. Tailored presentation and practical implementation of the recommendations represent the next crucial step.