Real-time effects of landscape characteristics on elderly people's well-being under air-heat exposure: A spring field study in central Italy.

Urban street configuration greatly affects pedestrian comfort and health by shaping the multi-domain environment. While its effects are evident during short-term exposure, prolonged and repeated exposure can contribute to long-term health effects. This study adopts a human-centered and multi-dimensional approach to explore how street geometry influences real-time physiological and psychological states responses in elderly pedestrians, a vulnerable group frequently exposed to outdoor environments by modifying heat and air quality conditions. Fourteen elderly participants walked along five paths in Perugia, Italy, during spring, while physiological signals were monitored using wearable devices, and microclimate and air quality factors were tracked using portable monitoring stations. After each walk, participants rated their environmental perception and psychological states. Results revealed that pedestrian paths with higher height-to-width ratios (ranging from 0.92 to 1.27 m) and elevated levels of nitrogen dioxide (NO2) and particulate matter (PM10) (up to 21 ppb and 18.77 μg/m3, respectively) significantly impaired air quality perception (p = 0.028, β = -0.273; p = 0.013, β = -0.312). Furthermore, both NO2 and PM10 concentrations were directly associated with changes in skin conductance levels and psychological indicators of emotional state, suggesting physiological and emotional stress responses. Conversely, the environment with a higher Green Visual Index showed more favorable relaxed-state responses. These findings demonstrate the interconnected impacts of urban form, air pollution, and green space on psychological well-being and physiological stress during spring conditions, providing insights for context-specific design strategies to enhance outdoor environmental quality and age-friendly urban resilience.