Association of residential green space with risk of sarcopenia and the role of air pollution: Evidence from UK Biobank

This study aims to explore the association between residential green space exposure and sarcopenia, and the role of air pollutants in the association. This study utilized data from the UK Biobank. Residential green space and natural environment were assessed by the percentage of land covered by greenness within 300 m and 1000 m buffers. Logistic regression models were used to explore the associations of green space and natural environment with possible sarcopenia and sarcopenia. We explored the mediating role of air pollution mixtures in the above associations. Interactions between green space and air pollution were assessed on the multiplicative and the additive scales. A total of 430790 participants were included in this study, and 23637 (5.5%) possible sarcopenia and 769 (0.2%) sarcopenia cases were identified. Each 10% increment of green space and natural environment coverage was associated with lower risks of possible sarcopenia (odds ratio (OR): 0.968, 95% confidence interval (CI): 0.961, 0.976 in green space; OR: 0.968, 95%CI: 0.962, 0.975 in natural environment) and sarcopenia (OR: 0.958, 95%CI: 0.920, 0.999 in green space; OR: 0.961, 95%CI: 0.926, 0.998 in natural environment). Population-attributable fraction analyses revealed that lower green space and natural environment levels could attribute to 8.8% and 8.5% of possible sarcopenia, 17.0% and 15.4% of sarcopenia. The associations of green space and natural environment with possible sarcopenia status could be partially explained by reducing air pollution. We also identified a significant multiplicative interaction between air pollution mixtures and green space on possible sarcopenia. In summary, higher green space and natural environment levels were associated with lower risks of possible sarcopenia and sarcopenia. Both modification and mediation roles of air pollution were found in the association between green space and possible sarcopenia. Therefore, expanding green space and reducing air pollution are crucial strategies for mitigating the risk of sarcopenia and promoting healthy aging.