What are the reasons for older adults' increased risk of impaired thermoregulation to both hyperthermia and hypothermia?

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From the Guidelines

Older adults are at increased risk for thermoregulation problems in both hot and cold temperatures due to decreased sensation, decreased metabolism, decreased reflexes, and decreased circulation. As people age, their sensory receptors become less sensitive, making it harder to detect temperature changes in the environment, which is a key factor in thermoregulation as noted in the 2024 American Heart Association and American Red Cross guidelines for first aid 1. Their metabolic rate slows down, reducing heat production within the body, and reflexes that trigger protective responses like shivering or sweating become slower and less efficient. Additionally, circulatory changes including reduced cardiac output and peripheral blood vessel elasticity impair the body's ability to redistribute heat effectively. These physiological changes mean older adults may not feel temperature extremes until they become dangerous, cannot generate heat efficiently when cold, respond more slowly to temperature challenges, and cannot move blood to or from the skin surface effectively to regulate body temperature. Key factors contributing to this vulnerability include:

  • Decreased sensation: making it harder for older adults to detect temperature changes
  • Decreased metabolism: reducing the body's ability to generate heat
  • Decreased reflexes: slowing down protective responses to temperature challenges
  • Decreased circulation: impairing the body's ability to redistribute heat effectively, as discussed in the context of hypothermia and heatstroke 1. This combination of factors makes older adults particularly vulnerable to both hypothermia and hyperthermia, requiring more careful monitoring and preventive measures, especially in the context of global urbanization and climate change 1.

From the Research

Reasons for Increased Risk of Thermoregulation in Older Adults

  • Decreased sensation: Older adults may have decreased sensation, making it more difficult for them to detect changes in temperature 2.
  • Decreased metabolism: Decreased metabolism in older adults can affect their ability to regulate body temperature 2, 3.
  • Decreased circulation: Decreased circulation can impair the body's ability to dissipate heat, making older adults more susceptible to heat-related illnesses 4, 3.
  • Decreased reflexes: Decreased reflexes can also contribute to the increased risk of thermoregulation in older adults, as they may not be able to respond as quickly to changes in temperature 2.

Physiological Changes Associated with Aging

  • Age-related changes in physiological functions, such as those in the musculoskeletal system, can affect the ability of older adults to maintain thermal homeostasis 2.
  • Structural skin changes and metabolic alterations can also impact the ability of older adults to regulate body temperature 2.
  • Age-related reductions in heat dissipating capabilities can increase the risk of heat-related morbidity and mortality in older adults 4, 3.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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