Impact of extreme weather events on food security among older people: a systematic review

Background: Climate change has intensified the frequency and severity of extreme weather events, disproportionately affecting vulnerable populations, including older people for which the literature is still limited. This systematic review investigated the impact of extreme weather events on malnutrition and food security among individuals aged 60 and older. Methods: A systematic search of PubMed/MEDLINE, Scopus, and Web of Science was conducted without restrictions (October 2024), and following PRISMA guidelines. Observational studies examining older adults exposed to extreme weather events (e.g., droughts, floods, heatwaves, hurricanes) and their effects on malnutrition or food security were included. The Newcastle-Ottawa Scale assessed study quality. Protocol was registered in PROSPERO (ID: CRD42024596910). Results: From 1,709 articles, six observational studies involving 265,000 participants (aged 60 years and over) were included. These studies spanned multiple geographies, with a concentration in the United States. Findings revealed a dual impact: while some studies reported protective factors, such as social support and economic stability, others highlighted increased malnutrition risk due to disrupted food supply, economic hardship, and inadequate adaptive responses. Heterogeneity in study designs, exposure definitions, and outcome measures limited comparability. Conclusion: Extreme weather events significantly impact malnutrition and food security among older adults, with outcomes influenced by socio-economic and geographical factors. Further longitudinal studies are needed to clarify causal pathways and inform targeted public health interventions to enhance resilience in aging populations.