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Heat is a Killer for Older People:
Tips for Prevention
Ability to sense heat is impaired in elderly
July 1, 2004 - In the Chicago heat wave of 1995,
more than 700 died. Last year, the world was shocked when thousands of
elderly men and women in France died as a result of a heat.
Heat-related illness can be a very serious problem,
especially among older men and women. Health concerns – or just the
normal physiological changes of aging – may make it difficult for older
people to handle high temperatures.
Mark Supiano, M.D., director of the Geriatric
Research, Education, and Clinical Center, chief of Geriatric Medicine at
the VA Ann Arbor Healthcare System, and a professor of internal
medicine/geriatrics at the University of Michigan Health System, warns
that summer heat can be dangerous and offers some tips to keep older
people safe this summer.
“Heat-related illnesses and their problems begin to
develop when the temperature exceeds 90 degrees Fahrenheit for more than
two or three days,” Supiano says. “When this is coupled with very high
humidity, the risks to older people are even worse.”
Older people who are at risk for heat-related
illness include those who:
•Have impaired mobility, especially those confined
to bed or those lacking transportation to leave their home for a cooler
destination;
•Take medications that can impair temperature regulation, such as those
with anticholinergic effects (e.g., Donnatal, and Benadryl), Thorazine,
and Parkinson’s disease medications;
•Take diuretics or other medications that lead to fluid loss, which can
compound the problems of dehydration;
•Have a chronic disease, such as congestive heart failure or diabetes;
•Live alone, have poor social support or a poor social network;
•Lack access to air conditioning.
“Even healthy older people are at risk of
developing heat-related problems, just because of the aging changes in
their physiology,” Supiano cautions.
There are a number of physiologic reasons why older
people are at particular risk of complications from high heat and
humidity. First, older people’s ability to sense heat is impaired. And
second, although younger people are able to discharge excess body heat,
this ability is impaired in older people.
Supiano says that poor circulation is one barrier
to adequately discharging excess body heat. Sweating is the other major
method we use to discharge heat and this ability, too, can be impaired
in older people.
“When outside temperatures are such that we cannot
lose heat as efficiently as we otherwise would, we’re at risk of
increasing the internal body temperature. As heat builds up in the body,
the early warning sign is heat exhaustion. If unrecognized and
untreated, this can lead progressively to heat stroke, hyperthermia,
coma and death,” Supiano says.
Signs and symptoms
•Heat exhaustion: extreme fatigue, muscle aches,
nausea, fever, clammy skin, rapid pulse, vomiting
•Heat stroke: confusion, agitation, hyperventilation, racing pulse,
lethargy, convulsions, high body temperature, eventual loss of
consciousness
Prevention
There are a number of factors that are critical to
preventing heat-related problems in older people. The first is
education, including being aware of the potential problems than can
contribute to heat-related illness. Once awareness is there:
•Make every effort to stay cool.
•Do what you can to get out of a hot environment.
•Stay in the shade.
•Limit outdoor activities.
•Use fans or seek areas that are air-conditioned, even if only for a few
hours at a time.
•If possible, take a cool bath.
•Wear loose fitting clothing in lighter colors.
•Drink plenty of fluids and consume adequate nutrition.
•Avoid alcohol.
•Increase salt and electrolytes intake, such as through eating salty
foods or drinking sports drinks like Gatorade.
Supiano points out that many older people are alone
and vulnerable, requiring a community response to these preventable
heat-related illnesses.
“Make certain your older neighbors are being cared
for, including access to adequate fluids and food. If they don’t have
air conditioning, offer to take them to a place that has a cool
environment, such as a shopping mall or senior center,” he says.
For more information, visit the following Web sites:
U-M Health Topics A-Z: Heatstroke
http://www.med.umich.edu/1libr/aha/aha_heatstro_crs.htm
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