Exposome and unhealthy aging: environmental drivers from air pollution to occupational exposures

Abstract

The aging population worldwide is facing a significant increase in age-related non-communicable diseases, including cardiovascular and brain pathologies. This comprehensive review paper delves into the impact of the exposome, which encompasses the totality of environmental exposures, on unhealthy aging. It explores how environmental factors contribute to the acceleration of aging processes, increase biological age, and facilitate the development and progression of a wide range of age-associated diseases. The impact of environmental factors on cognitive health and the development of chronic age-related diseases affecting the cardiovascular system and central nervous system is discussed, with a specific focus on Alzheimer's disease, Parkinson's disease, stroke, small vessel disease, and vascular cognitive impairment (VCI). Aging is a major risk factor for these diseases. Their pathogenesis involves cellular and molecular mechanisms of aging such as increased oxidative stress, impaired mitochondrial function, DNA damage, and inflammation and is influenced by environmental factors. Environmental toxicants, including ambient particulate matter, pesticides, heavy metals, and organic solvents, have been identified as significant contributors to cardiovascular and brain aging disorders. These toxicants can inflict both macro- and microvascular damage and many of them can also cross the blood-brain barrier, inducing neurotoxic effects, neuroinflammation, and neuronal dysfunction. In conclusion, environmental factors play a critical role in modulating cardiovascular and brain aging. A deeper understanding of how environmental toxicants exacerbate aging processes and contribute to the pathogenesis of neurodegenerative diseases, VCI, and dementia is crucial for the development of preventive strategies and interventions to promote cardiovascular, cerebrovascular, and brain health. By mitigating exposure to harmful environmental factors and promoting healthy aging, we can strive to reduce the burden of age-related cardiovascular and brain pathologies in the aging population.

Keywords: Accelerated aging; Aging; Biological age; Environmental pollution; Exposome; Toxicology.

Fig. 1

Conceptual model illustrating the contribution of environmental drivers to unhealthy aging, characterized by accelerated aging processes, increased biological age, and the development and progression of various age-associated diseases. Environmental toxicants (depicted in orange) play a key role in promoting age-related cardiovascular, cerebrovascular, and brain pathologies, as well as the pathogenesis of age-associated diseases in other organ systems. These toxicants exacerbate fundamental molecular and cellular aging processes (depicted as roots), which serve as the underlying mechanisms. The consequences of accelerated vascular aging induced by toxicants give rise to the genesis of micro- and macrovascular pathologies, including atherosclerotic vascular diseases, cerebral small vessel disease, and Alzheimer’s disease. Furthermore, many of these toxicants have the ability to cross the blood–brain barrier, leading to neurotoxic effects, neuroinflammation, and neuronal dysfunction, promoting the genesis of neurodegenerative diseases and cognitive decline. Clinical disciplines, biogerontology, and environmental toxicology, along with public health research, traditionally focus on specific age-related diseases (depicted as leaves), mechanisms of aging (depicted as roots), and environmental risk factors, respectively. Geroscience, as an integrative scientific field, considers the interaction between all these levels, facilitating a comprehensive understanding of the complex relationship between environmental factors and unhealthy aging