The narrative review focuses on a problem, atmospheric pollution and the elderly mental decay, detailing literature data and evidence on the double aspect of the potential harm derived from outside air and indoor air. Pertinent studies have been reviewed starting from the original works, adding comments to the published outcomes and highlighting considerations regarding the possible relationship between atmospheric pollution and cognitive decay. After reviewing the first laboratory works and the first experimental evidences on the penetration and diffusion of pollutants in the human organism, general epidemiological works have been taken in consideration as well. More recently a few neurophysiological tests have been used to assess pollution effects on the elderly, with the aim of performing better structured studies in terms of methodology and outcomes. Epidemiology works specifically addressed to the mental impairment of the aged population have been analysed and commented in this review A few pertinent reviews on these topics have been included as well, documenting the increasing interest in this topic in the latest years. Furthermore some recent contrasting literature, based on hormesis principles, which questions the negative impact of air pollutants, especially at low dose, has been included and discussed. Notwithstanding the relative growing body of literature on pollution in the elderly, a long and complex path is expected before reaching evidence-based literature data and recommendations about the possible negative influence of pollutants in the cognitive decay and more in general in the pathologic senescence.

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