Abstract
A systematic review and narrative synthesis was completed to explore the relationships between climate change, the care of older people, and corresponding expenditure. While literature on these topics exists individually, a gap remains in linking all three. The interconnected challenges of an aging global population with increasing care needs and the rising frequency and severity of climate and weather events emphasize the urgency of minimizing related risks and their financial costs. Three databases were systematically searched from 1980–2023, identifying 36 peer-reviewed articles. Evidence suggests that climate and weather exposures lead to spending for recovery, preparedness, lifestyle, public administration, health and care, and temperature regulation. The narrative synthesis, structured around the disaster management phases of preparedness, response, and recovery, revealed several behavioral, environmental, economic, social, sociodemographic, and structural determinants that appear to influence older peoples’ reactions to climate and weather events and financial consequences. Three key influences present across the narrative seem to shape spending and care outcomes: having strong support systems, access to user-friendly information, and existing economic resources. Available literature on preparedness and recovery was limited, as most studies related to response expenditure. Future research should adopt a life-course approach to aging and preparedness using longitudinal designs to investigate how behaviors and choices made earlier in an individual’s life affect care, response, and recovery expenditure in older age. More stratified results would further allow for analysis of vulnerable subgroups and a clearer understanding of when climate and weather-related expenditures emerge. This review indicates the need for research and policy to consider the interconnected nature of the climate crisis. More focus should be given to preparedness efforts and behavior change to reduce the impact of climate and weather events on future expenditure and care needs. Other The protocol for this research has been published in PROSPERO with the registration number CRD42023443060. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-27435-9.