{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T03:09:44Z","timestamp":1785899384715,"version":"3.56.0"},"reference-count":47,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Physical disability reflects the cumulative burden of chronic conditions. Although generally progressive, episodes of disability can be followed by periods of recovery; therefore, there is a need to identify modifiable risk factors that contribute to the dynamic development of disability.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To investigate air pollution as a modifiable risk factor of transitions between states of no physical function limitation, physical function limitations, and activities of daily living (ADL) disability.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study included respondents older than 50 years from the nationally representative Health and Retirement Study (HRS) who participated in at least 2 interviews between 2000 and 2016. Data analysis was conducted from July 2023 to August 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n \n Ten-year average ambient concentrations of particulate matter with a diameter of 2.5 \u00b5m or less (PM\n 2.5<\/jats:sub>\n ), PM with a diameter between 10 and 2.5 \u00b5m (PM\n 10-2.5<\/jats:sub>\n ), nitrogen dioxide (NO\n 2<\/jats:sub>\n ), and ozone (O\n 3<\/jats:sub>\n ) were estimated at respondent residential addresses preceding each survey using spatiotemporal models.\n <\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Physical disability states were assessed using self-reported mobility and Activities of Daily Living (ADL). To examine associations of exposure to air pollution with transitioning between states of physical disability, multistate models, adjusted for individual- and area-level covariates, were used.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The sample included 29\u202f790 respondents (mean [SD] age, 63 [11] years; 16\u202f878 [57%] women; 3371 [11%] Hispanic, 5240 [18%] non-Hispanic Black, and 20\u202f314 [68%[ non-Hispanic White), who were followed up for a mean (SD) of 8 (6) years. IQR-increments in PM\n 2.5<\/jats:sub>\n , PM\n 10-2.5<\/jats:sub>\n , and NO\n 2<\/jats:sub>\n concentrations were mostly associated with greater hazards of transitioning from a state of no physical function limitation toward disability; a 1-IQR increment for PM\n 2.5<\/jats:sub>\n was associated with lower odds of a reverse transition. For example, in the single-pollutant model, a 1-IQR higher PM\n 2.5<\/jats:sub>\n concentration was associated with a hazard ratio (HR) of 1.06 (95% CI, 1.03-1.09) for transitioning from no physical function limitations to physical function limitations and an HR of 0.96 (95% CI, 0.93-0.99) for reverting back to healthy physical function from physical function limitations. By contrast, a 1-IQR higher O\n 3<\/jats:sub>\n concentration was associated with lower hazards of transitioning from no physical function limitations to physical function limitations (HR, 0.92; 95% CI, 0.86-0.98) and ADL disability (HR, 0.89; 95% CI, 0.81-0.97).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n These findings suggest that air pollution may affect the progression of physical disability and hinder recovery in later life.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.58699","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T16:30:34Z","timestamp":1770827434000},"page":"e2558699","source":"Crossref","is-referenced-by-count":1,"title":["Air Pollution and the Progression of Physical Function Limitations and Disability in Aging Adults"],"prefix":"10.1001","volume":"9","author":[{"given":"Jiaqi","family":"Gao","sequence":"first","affiliation":[{"name":"Department of Epidemiology, University of 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