There is scarce research regarding non-communicable diseases (NCDs) and the environment in Panama. Assessing the relationship between climate and pollution variables and deaths from selected NCDs (chronic respiratory disease, cardiovascular disease and diabetes) in adults aged 65 years or more living in Panama City between 2003 and 2014. From different sources we collected monthly series of: 1) death by selected NCDs (Instituto Nacional de Estadística y Censo), 2) air pollutants PM₁₀ and NO_2, (from the SIA -UP-) and sea temperatures change (from NOAA), and 3) climate variables (from Empresa de Transmisión Eléctrica S.A).  An Environmental Index (EI) was constructed using the principal component factor analysis technique, derived from previous cointegration and stable seasonality analyses of all study variables using seasonal decomposition using the Additive Method of X-12 ARIMA. A relationship between mortality from the diseases studied and variations in environmental condition by cointegration tests and the stable seasonality for the EI was found (p<0.01), demonstrating joint pro-seasonality with the NCDs.  The factorial loads comprising EI were maximum temperature: 0.23215; relative humidity: -0.52616; rainfall: -0.19430, wind speed: 0.21889; and PM₁₀: 0.10570. During June and July occurred the highest mortality for chronic respiratory disease and cardiovascular disease, respectively. Diabetes highest mortality happened in September and October.  We report a procyclical evolution according to El Niño and La Niña severity with EI. EI and its monthly relationship to deaths caused by selected ENTs might be an early warning tool that allows mitigation or adaptation measures for the population aged 65 and over. Although the relationship between environmental variations due to climate and pollution has been demonstrated in a statistical way, with mortality in the study variables, it is important deepening the underlying interactions between climate and pollution.