Short-term effects of ambient temperature on non-external and cardiovascular mortality among older adults of metropolitan areas of Mexico.

Multi-city studies assessing the association between acute exposure to temperature and mortality in Latin American are limited. To analyze the short-term effect of changes in temperature (increase and decrease) on daily non-external and cardiovascular mortality from 1998 to 2014, in people 65 years old and over living in 10 metropolitan areas of Mexico. Analyses were performed through Poisson regression models with distributed lag non-linear models. Statistical comparison of minimum mortality temperature (MMT) and city-specific cutoffs of 24-h temperature mean values (5th/95th and 1st/99th percentiles) were used to obtain the mortality relative Risk (RR) for cold/hot and extreme cold/extreme hot, respectively, for the same day and lags of 0-3, 0-7, and 0-21 days. A meta-analysis was conducted to synthesize the estimates (RRpooled). Significant non-linear associations of temperature-mortality relation were found in U or inverted J shape. The best predictors of mortality associations with cold and heat were daily temperatures at lag 0-7 and lag 0-3, respectively. RRpooled of non-external causes was 6.3% (95%CI 2.7, 10.0) for cold and 10.2% (95%CI 4.4, 16.2) for hot temperatures. The RRpooled for cardiovascular mortality was 7.1% (95%CI 0.01, 14.7) for cold and 7.1% (95%CI 0.6, 14.0) for hot temperatures. Results suggest that, starting from the MMT, the changes in temperature are associated with an increased risk of non-external and specific causes of mortality in elderly people. Generally, heat effects on non-external and specific causes of mortality occur immediately, while cold effects occur within a few days and last longer.