We are experiencing the hottest days on record. Heat waves blanketed the Northern Hemisphere this week, with temperatures reaching 100 degrees Fahrenheit on three continents.

Extreme heat can be deadly for anyone, but older adults are uniquely vulnerable. In the heat wave that suffocated Europe in the summer of 2022, people 65 and older represented approx. 90 percent of heat-related deaths.

Experts say three factors combine to increase older adults’ risk: biological changes that occur naturally with age, higher rates of age-related chronic diseases and greater use of medications that can alter the body’s response to heat.

Here’s how to assess the risk of heat illness for you or a loved one and how to stay safe.

The human body has two main mechanisms for cooling itself: sweating and increasing blood flow to the skin. In older adults, these processes are compromised – they sweat less and they have poor circulation compared to younger adults.

“Because older individuals are not able to release the heat as well, their core temperature goes higher and higher,” said Craig Crandall, a professor of internal medicine specializing in thermoregulation at the University of Texas Southwestern Medical Center. “And we know that core temperature is the primary driver of heat injury and death.”

These changes do not suddenly appear when someone reaches 65; they begin gradually in middle age, said Glen Kenny, a professor of physiology at the University of Ottawa. “It’s a slow decline,” he said. But you start to see noticeable differences “by the age of 40, without question.”

Chronic conditions that are more common in old age, especially cardiovascular disease and diabetes, can exacerbate these problems. A diseased heart is unable to pump as much blood, further reducing blood flow to the skin. And if the nerves are affected in people with severe diabetes, the body may not get the message that it needs to sweat. (Younger people with these conditions are also at greater risk for heat problems.)

As people age, they also stop feeling as thirsty and therefore they tend to drink less. In hot conditions, this can cause them to dehydrate more quickly, which is “extremely detrimental to temperature control,” Dr. Crandall said.

In addition, some older adults, especially if they have some form of dementia or cognitive decline, may also not perceive temperature changes. As a result, they will not respond appropriately to heat, both biologically (through sweat) and behaviorally (by moving somewhere cool).

Finally, some medications can affect people’s hydration, blood flow, and even the sweat response, so be sure to ask your doctor about any medications you’re taking.

Of course, not everyone of the same age responds to heat in the same way. Older adults who are physically fit are usually more resilient, Dr. Crandall said, because they have better blood flow and they sweat more than their sedentary peers.

People often think that heat has to be extreme (say, over 100 degrees) to cause illness, but in older adults, signs of heat exhaustion can appear when temperatures. are as low as 80 degrees.

“Twenty-year-olds can go out in 80-degree weather for hours and generally be fine,” said Dr. Angela Primbas, a geriatrician at UCLA Health. “That doesn’t apply to older adults.”

Physical exertion increases a person’s risk for heat illness because the body begins to generate even more heat. On hot days, Dr. Primbas said, older adults and people with serious health conditions should limit outdoor activities such as walking and gardening to the cooler mornings and evenings, take frequent breaks and drink plenty of water. Also listen to your body: If the activity starts to feel more difficult than normal, this is a signal to stop and find a place to cool down.

Signs of dehydration or heat exhaustion include dizziness, light-headedness, headache, racing heart or feeling lethargic. Low energy – if someone isn’t talking or interacting as much as usual – is especially important to look out for in people with cognitive impairment, who may not realize how hot they are or be able to express it.

While older adults face unique challenges when it comes to staying warm, the ways to cool down are the same for any age. If you or a loved one starts experiencing any of the above symptoms, the best thing you can do is go somewhere that has air conditioning, Dr. Kenny said. The indoor temperature doesn’t have to be “subzero,” he added, just aim for 77 degrees or less. If AC is not available in the home, check if there is a local one cooling center.

In the absence of air conditioning, water is “extremely helpful in reducing our risk for heat injury,” Dr. Crandall said. He advised rubbing an ice cube over your skin, splashing yourself with cool water, soaking your shirt or taking a cool shower or bath.

Whatever you do, take heat seriously. It is the No. 1 cause of weather-related deaths in the United States, and many of those deaths are preventable.

By admin

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