Background Extreme temperatures are associated with negative health outcomes, in particular for older adults with pre-existing conditions. While climate change is expected to increase exposure to temperature levels that are detrimental for health, little is known about how dementia shapes vulnerability to extreme temperatures. Methods We leveraged repeated quarterly individual-level health claims from 2004 to 2019 on 250,000 individuals in Germany aged 50 years and above with information on key neurodegenerative diseases such as dementia. We linked data on the location of residence of these individuals with high resolution gridded meteorological data. In our empirical analysis, we applied an individual-level Fixed Effects model to estimate how temperature affects the single patient’s probability of hospitalization and death, adjusted for seasonality and comorbidities. Results Our findings reveal that heat and cold exposure increase the risk of death. Conversely, the association between extreme temperatures and hospital admissions is more nuanced showing an increase only with cold exposure. Stratifying the analysis by individuals affected by dementia, we observe heat to increase mortality only for individuals with dementia and cold to determine an 8 times larger impact on them and a larger increase in hospitalization. Also, we observe individuals aged above 80 and with dementia do be the most at risk of death with exposure to cold and in particular heat. Conclusion Our study contributes to the growing body of evidence on the health impacts of climate change and emphasizes the need for targeted strategies to protect vulnerable groups, particularly patients with dementia, from adverse temperature effects.

中文翻译：

---

德国的痴呆症和温度相关死亡率和住院风险


背景 极端温度与负面的健康结果有关，特别是对于患有既往疾病的老年人。虽然预计气候变化会增加暴露于对健康有害的温度水平，但人们对痴呆如何塑造对极端温度的脆弱性知之甚少。方法 我们从 2004 年到 2019 年对德国 250,000 名 50 岁及以上的人进行了重复的季度个人层面的健康声明，其中包含有关痴呆等关键神经退行性疾病的信息。我们将这些人的居住地数据与高分辨率网格化气象数据联系起来。在我们的实证分析中，我们应用了个体水平的固定效应模型来估计温度如何影响单个患者住院和死亡的可能性，并根据季节性和合并症进行调整。结果我们的研究结果表明，热和冷暴露会增加死亡风险。相反，极端温度与住院之间的关联更为微妙，仅显示寒冷暴露会增加。按受痴呆影响的个体对分析进行分层，我们观察到高温只会增加痴呆个体的死亡率，而寒冷则确定对他们的影响是他们的 8 倍，住院率增加更大。此外，我们观察到 80 岁以上和患有痴呆症的人在暴露于寒冷，尤其是高温下确实最有可能死亡。结论 我们的研究为气候变化对健康影响的越来越多的证据做出了贡献，并强调了制定针对性策略以保护弱势群体，特别是痴呆患者免受不利温度影响的必要性。