Just how hot is it in your neighborhood these days?  We are sizzling!

Not-so-fun-fact:  Your body’s ability to cool off diminishes with age.  That’s why older adults are even more susceptible to heat related ailments like heat exhaustion and heat stroke.

The most severe type of heat-related illnesses is heat stroke, which can be fatal.  This medical emergency occurs when the body temperature rises above 104°F and can’t cool down.  High body temperature can cause irreversible brain damage, and if not treated properly, heatstroke can lead to seizures, coma, and death.

Classic heatstroke occurs most commonly during heat waves and in people over 70 who have underlying medical conditions and an impaired ability to get cooled or hydrated.

The onset of heatstroke can be rapid, with progression to a life-threatening state within minutes. Signs and symptoms vary and can include:

  • Hot, dry skin (often with no sweating)
  • Rapid pulse
  • Flushed face
  • Rapid, shallow breathing
  • Confusion or disorientation
  • A change in behavior, such as agitation or combativeness
  • Dizziness, fainting, or loss of consciousness
  • Nausea or vomiting
  • Staggering gait

Risk factors in older adults 

Health factors that can increase the risk for classic hyperthermia  (heat related illnesses) include:

  • Poor circulation
  • Dehydration
  • Obesity
  • Inefficient sweat glands, which become more common with age
  • Chronic illnesses such as heart, lung, and kidney diseases; diabetes; respiratory disorders; and skin disorders such as psoriasis, eczema, and scleroderma
  • A salt-restricted diet
  • Use of certain drugs that affect the body’s hydration status and response to heat, including tricyclic antidepressants; anticholinergics, such as antihistamines and antiparkinsonian agents; and certain heart and blood pressure drugs, notably beta-blockers, calcium channel blockers, and diuretics
  • Mental states that affect judgment, such as dementia
  • Disabilities or illnesses that restrict mobility, such as being bedridden or unable to take care of oneself

Lifestyle factors that increase susceptibility to classic heatstroke include:

  • Living in an extremely hot residence
  • Living alone or social isolation
  • Not having convenient access to transportation, which prevents people from seeking respite in air-conditioning
  • Overdressing, especially among older people, who may not feel the effects of a heat wave because physical perceptions of temperature decrease as people age
  • Drinking alcoholic beverages

Common sense steps to ward off heat related illness include:

  • Staying indoors in air-conditioning as much as possible
  • Staying hydrated – older adults are less likely than younger people to recognize thirst
  • Modifying physical activity
  • Taking a cool bath or shower
  • Wearing appropriate clothing, like loose fitting, light-colored lightweight garments that “breathe” and a wide brimmed hat

If you suspect someone has heatstroke, call 911 immediately, and then try to cool the person down by:

  • Moving them out of the sun into a cool place
  • Having them lie down on their back, with legs elevated
  • Applying an ice pack or cold towels to the back of the neck, armpits and groin
  • Splashing or spraying the person with a garden hose
  • Offering cool (not cold, which can cause stomach cramps) water, juice, or a sports drink, but only offer water if the person is alert and can swallow

Play it cool this summer!

UC Berkeley School of Public Health Wellness Letter

June 16, 2022

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