Neighborhood Greenspace Enhances Cardiopulmonary Function in Healthy Older Adults: A Multiomics Analysis from the BAPE Study

Urban greenspace measured by remote sensing has been linked to population health benefits, yet evidence on cardiopulmonary effects at the microenvironmental street level and related molecular mechanisms in older adults remains limited. We conducted a repeated-measures panel study of 76 healthy older adults in Jinan, China, with five monthly clinical examinations. Pedestrian-level neighborhood greenspace exposure was quantified using AI-based semantic segmentation of street-view videos collected around participants’ residences. Pulmonary and cardiovascular function were repeatedly assessed, alongside multiomics profiling of blood and urine samples. Linear mixed-effect models were used to examine associations of greenspace exposure with cardiopulmonary outcomes, while causal inference tests and integrative pathway analyses explored potential biological mechanisms. Higher neighborhood greenspace exposure was significantly associated with improved forced vital capacity (FVC), but not with other pulmonary indices or cardiovascular outcomes. In fully adjusted models, each interquartile range (IQR) increase in greenspace exposure was associated with a 189.9 mL (95% CI: 35.9 to 343.2 mL) increase in FVC. Multiomics analyses identified mediating metabolites, lipids, transcripts, and enriched pathways related to immune activation, nitric oxide metabolism, and DNA repair. These findings suggest that pedestrian-level greenness exposure may enhance pulmonary function in older adults through specific biological pathways, highlighting the importance of microscale urban greening for respiratory health.