Heat Illness in Older Adults

What is heat illness?

Heat illness is a problem that can happen when your body gets overheated. The medical term for heat illness is hyperthermia.

Adults over 65 have a higher risk of heat illness than younger adults.

How does it occur?

Heat illness usually happens after long exposure to hot temperatures. It can also be caused by a high fever associated with illness or exercising too strenuously. Overdressing or wearing the wrong kinds of fabrics for hot weather, overeating, not drinking enough fluids, or drinking too much alcohol can also contribute to becoming overheated.

Factors that may increase your risk of getting overheated and having heat illness include:

• Poor circulation, sweat glands that don’t work well, and changes in the skin caused by the normal aging process.
• Heart, lung, and kidney diseases, as well as any illness that causes general weakness or fever.
• High blood pressure or other health conditions that require changes in diet.
• Medicines such as diuretics, sedatives, tranquilizers, and certain heart and blood pressure drugs, or combinations of drugs, that can make it harder for your body to cool itself through perspiration. Do not, however, stop taking prescribed medicine until you talk with your healthcare provider.
• Being very overweight or underweight.
• Living in a home without an air conditioner or fans.
• Not staying indoors on especially hot and humid days, particularly when there is an air pollution alert in effect.

What are the symptoms of heat illness?

As your body gets hotter and is unable to cool down, symptoms progress. First, you may become dehydrated and get heat cramps. If not treated, your symptoms could become more severe and you could eventually develop a more serious problem, such as heat exhaustion or heatstroke.

Heat cramps: Symptoms of heat cramps include muscle pains or spasms (most commonly in the abdominal, arm, or leg muscles).

Heat exhaustion: Symptoms of heat exhaustion include:

• dizziness
• weakness
• nausea or vomiting
• muscle aches
• headaches
• increased sweating

Heatstroke is a life-threatening condition in which the body temperature rises rapidly to 104°F (40°C) or higher and the body's heat-regulating mechanism breaks down. Heatstroke may cause damage to the kidneys, heart, lungs, muscles, liver, intestines, and brain. Symptoms of heatstroke:

• no sweating
• confusion and disorientation
• erratic behavior
• agitation
• seizures
• coma
• injury to body organs

How is it treated?

Heat cramps can be treated by drinking a lot of fluids, massaging the cramped area, and stretching the cramping muscles. Heat cramps may improve more rapidly if you drink a sports drink that contains salt and other electrolytes rather than drinking plain water.

To help treat heat exhaustion:

• Stop exercising or any other activity.
• Get out of the sun and go into a cool place, preferably with air conditioning.
• Lie down and rest.
• Loosen clothing.
• Drink plenty of cool nonalcoholic fluids, such as water, clear juice, or a sports drink. Do not drink iced drinks. If you cannot sip fluids, you probably need intravenous (IV) fluids at a hospital.
• Cool your body with a fan, spray, or washcloth, or sit in a cool bath.
• Get medical attention if the symptoms get worse or last longer.

Caution: You may need to be careful about how much you drink if you are on a diet that limits your fluids or if you take diuretics. Talk to your healthcare provider about this.

Someone with symptoms of heatstroke needs to be treated in a hospital as soon as possible. Call 911 right away. Follow the treatment for heat exhaustion until medical help arrives. Without medical attention, heatstroke is often deadly, especially for older people.

How can I help take care of myself and prevent heat illness?

• Avoid strenuous activity in hot or humid weather. Stay out of the hot sun whenever you can.
• When you are outdoors, dress in lightweight, light-colored, loose-fitting clothing. Natural fabrics such as cotton are best. Wear a hat or use an umbrella for shade.
• Take time to get used to a new climate before being very active or staying in the sun. If you are not used to the heat, get accustomed to it slowly by exposing yourself to it briefly at first and increasing the time little by little.
• Drink plenty of cool nonalcoholic fluids whenever you spend a lot of time in the sun or in a hot environment, according to your healthcare provider’s advice. Drink extra fluids when you sweat, even if you are not thirsty.
• Try to keep at least 1 room in your home cool, especially if you live alone. During the warm season, open windows at night. Cover windows when they are exposed to direct sunlight. Keep curtains, shades, or blinds drawn during the hottest part of the day. If possible, use air conditioners. Air conditioners should be set below 80° F (27° C). If your home does not have air conditioning, keep a fan running.
• If your home remains very hot, stay with friends or family. During a heat wave, check with your city’s emergency services to find out where there are cool buildings you can go to. For example, you might visit air-conditioned places such as libraries, shopping malls, and theaters.
• Avoid hot, heavy meals. Don’t do a lot of cooking, eat small meals, and limit alcoholic drinks. Try to avoid using the oven.
• If you take medicines, talk to your healthcare provider to see if any of your medicines make it more likely that you will have problems in the heat.
• If you have a headache, nausea, and fatigue after exposure to heat, you may have a heat illness and should call your healthcare provider.