Why Older Adults Are at Higher Risk
Older adults have accumulated PFAS body burden over decades of exposure from water, food, and consumer products. Because PFAS are not metabolized and are eliminated slowly, blood PFAS levels generally increase with age until exposure cessation or death. Adults over 60 typically show higher serum PFAS levels than younger adults, reflecting this lifetime accumulation.
Age-related decline in kidney and liver function reduces the already-limited ability of the body to eliminate PFAS. Reduced glomerular filtration rate slows urinary PFAS excretion, further extending elimination half-lives in older individuals.
Health Outcomes in Aging With PFAS
PFAS exposure is associated with several conditions that disproportionately affect older adults: cardiovascular disease, cancer, type 2 diabetes, thyroid dysfunction, and cognitive decline. The superposition of PFAS-related biological effects on the normal aging process may accelerate the development of age-related diseases.
A prospective study of Medicare beneficiaries found that those residing in ZIP codes with PFAS-contaminated water had higher rates of hospitalization for cardiovascular events and kidney disease compared to those with clean water, even after adjusting for socioeconomic and demographic factors.
Geriatric Care Considerations
Geriatricians and primary care physicians managing older patients with multiple chronic conditions should consider PFAS exposure history as a contributing factor. In patients with polypharmacy, PFAS-induced alterations in liver enzyme expression may affect drug metabolism, though this area requires further study.
Ensuring access to PFAS-filtered water for elderly patients — particularly those in care facilities in contaminated regions — is an actionable protective measure. Caregiver education about PFAS sources and reduction strategies is an important component of comprehensive geriatric care.