Climate-Related Mental Health Outcomes in Older Adults: A Scoping Review of Social Determinants of Vulnerability and Resilience

Abstract To map evidence on climate-related exposures and mental health outcomes among older adults, and to characterise how social determinants of health are framed as vulnerability, protective, and recovery-related factors. A scoping review was conducted in accordance with the Joanna Briggs Institute Manual for Evidence Synthesis and reported according to the PRISMA-ScR guidelines. The protocol was registered in the Open Science Framework. Searches were performed in PubMed/MEDLINE, Scopus, Web of Science, LILACS, SciELO, PsycINFO, the Cochrane Library, and Google Scholar, without language or date restrictions. Older adults were defined as individuals aged 60 years or older, consistent with the World Health Organization operational threshold. Study selection was conducted by two independent reviewers. Data extraction was followed by descriptive and thematic synthesis. Co-occurrence matrices were calculated only for empirical sources to reduce double counting from reviews and commentaries. A total of 740 records were identified; and 27 sources were included in the final synthesis. The principal exposure types mapped were heatwaves/extreme heat, floods, hurricanes/storms, wildfires, smoke exposure, and air pollution, including fine particulate matter with an aerodynamic diameter of 2.5 μm or less (PM2.5). Anxiety, stress, depression, and post-traumatic stress disorder were the most recurrent mental health outcomes. The mapped evidence suggests that income, social support, social isolation, education, chronic disease/functional limitation, housing/geography, gender, and access to services or information frequently co-occurred with adverse outcome profiles. The available literature suggests that climate-related mental health risks among older adults are heterogeneous and socially patterned. The mapped evidence is consistent with a socioecological and cumulative vulnerability interpretation, although causal mediation cannot be established by this scoping review. Integrating mental health into climate adaptation strategies requires psychosocial risk stratification, continuity of care, and strengthening of community and service networks.