Environmental Scan of Tools and Frameworks Assessing Climate-Related Health Vulnerabilities in Older Populations.

Background and objectives: Climate change is intensifying health inequities, particularly among older adults who face heightened vulnerability to climate-related hazards. With the global senior population estimated at one billion and projected to increase by 20% by 2050, there is urgent need for health systems to identify and respond to their specific risks. This environmental scan aims to map and evaluate existing tools and frameworks used to assess climate-related health vulnerabilities in older adults, with a focus on informing equitable healthcare planning and system resilience.

Research design and methods: Five electronic databases (ProQuest, Scopus, PubMed, CINAHL, Embase) and grey literature were searched. The PRISMA checklist was utilised to guide the review process and the Joanna Briggs Institute (JBI) tool was used to appraise the studies. A total of 23 studies were identified and included in this review.

Results: Of the 23 identified tools and frameworks, only two were explicitly designed for older adult populations and predominantly focused on heat-related risk assessments, accounting for 74% of climate hazards addressed. Most tools relied on general population indicators, potentially under-estimating age-specific vulnerability related to functional decline, care dependency, and social isolation. Studies were concentrated in East Asia and the Pacific and North America, with no representation from South Asia or the Middle East and North Africa, highlighting significant regional gaps. The majority of studies remain anchored in pre-2021 IPCC vulnerability models with limited update of newer risk-based frameworks.

Discussion and implications: This environmental scan highlights gaps for age-specific vulnerability assessment tools that capture the unique climate-risks facing older adults. Future work should explicitly adopt and clarify IPCC frameworks with standardised domain classifications, and integrate geriatric-specific indicators to improve risk assessment accuracy for this growing demographic.