Impairments to Thermoregulation in the Elderly During Heat Exposure Events.

Alison Millyard,Andrew M Edwards,David B Pyne,Saul R Bloxham,Joe D Layden

doi:10.1177/2333721420932432

Abstract

Heat waves represent a public health risk to elderly people, and typically result in an increased rate of hospital admissions and deaths. Studies of thermoregulation in this cohort have generally focused on single elements such as sweating capacity. Sweating capacity and skin blood flow reduce with age, reducing ability to dissipate heat. Perception of effort during heat exposure is emerging as an area that needs further investigation as the elderly appear to lack the ability to adequately perceive increased physiological strain during heat exposure. The role of the gut and endotoxemia in heat stress has received attention in young adults, while the elderly population has been neglected. This shortcoming offers another potential avenue for identifying effective integrated health interventions to reduce heat illnesses. Increasing numbers of elderly individuals in populations worldwide are likely to increase the incidence of heat wave-induced deaths if adequate interventions are not developed, evaluated, and implemented. In this narrative-style review we identify and discuss health-related interventions for reducing the impact of heat illnesses in the elderly.

Highlights

Tens of thousands of deaths have been caused by heat waves across Europe since 2000 (European Environment Agency [EFA], 2016)
Pacing research has shown that self-paced cycling output and running speed are reduced during exercise in hot compared with cool conditions, and this occurs prior to an increase in core temperature (Junge et al, 2016; Tucker & Noakes, 2009)
A key issue is the apparent lack of perception of thermal and physical strain during heat exposure in elderly individuals, and its influence over behavioral thermoregulation

Summary

Introduction

Tens of thousands of deaths have been caused by heat waves across Europe since 2000 (European Environment Agency [EFA], 2016). This narrative-style review examines relevant studies on the interaction between the cardiovascular and immune systems and behavioral responses to heat stress in an elderly population. Evaluation of these studies will inform practitioners working with this population, and researchers investigating the effects of interventions aimed at reducing the impact of heat stress at both an individual and community level.

Results

Conclusion