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Heat Wave Threatens Older Americans

Who’s at risk and how to protect yourself

En español | It's astonishing but true: More Americans die each year from extreme heat than from hurricanes, lightning, tornadoes, floods and earthquakes combined. And yet unlike those natural disasters, heat-related deaths are completely preventable.

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With excessive heat warnings in effect this week for more than 30 states, health officials fear that susceptible older Americans may be at risk for illness or death. The federal Centers for Disease Control and Prevention (CDC) reports that 40 percent of heat-related deaths occur in those 65 and older, and men account for two-thirds of these deaths in all age groups.

This week’s blistering triple-digit weather has put about 141 million people across the country under heat advisories and warnings. As many as 22 possible heat-related deaths already have been reported, including a 69-year-old Blackwell, Okla., man who died from hyperthermia after mowing a lawn.

As the experts at the CDC point out, air conditioning is the number one protection against the dangers of extreme heat. Yet sometimes those most vulnerable — people 65 and older, children, those who are overweight or have medical conditions — don’t have access to air conditioning or can’t afford it.

Heat and heart health

The extreme heat is particularly dangerous for those 65 and older for a number of reasons: Their bodies don’t adjust as well to extremes in temperature, and they are more likely to have a chronic medical condition or to be taking prescription medicines that affect the body’s ability to cool itself, says Colleen Keller, director of the Hartford Center of Geriatric Nursing Excellence at Arizona State University.

Diuretics and some heart medications, in particular, can affect how well a person’s body responds to the heat, she says.

In fact, cardiovascular problems play the biggest role in heat-related deaths, according to CDC records. Of the 3,442 deaths from extreme heat between 1999 and 2003, cardiovascular disease was recorded as the underlying cause of death in nearly 60 percent of the cases.

People suffer from heat-related illness when their bodies are unable to cool down sufficiently. Although sweating normally helps the body cool, during extremely hot weather that’s sometimes not enough, especially if the person is dehydrated, overweight or suffering from other health problems.

If a person can’t get to an air-conditioned place to cool down and drink fluids, the body’s temperature will begin to rise, similar to having a high fever. If it reaches 103 degrees or higher, death or permanent damage to the brain and other organs can result.

Staying cool

The symptoms of heat-related illness can be slow to develop, “and often the elderly do not realize they are succumbing to the heat,” says CDC epidemiologist Rebecca Noe. Many older people typically don’t drink enough liquids, she adds, which increases their difficulty coping with stifling weather.

Noe encourages friends and family members to check on older neighbors, especially those who live in homes without air conditioning. “People with heat exhaustion will feel faint, dizzy, nauseous and their pulse can be fast and weak. If you take their temperature and it’s above normal, that’s also an indication,” she says.

In Arizona, where daily highs typically soar above 100 degrees, Keller urges older people to drink plenty of cool fluids and eat cold fruit with high water content, like watermelon, cantaloupe and apples. Putting cool cloths under the armpits and around the neck is also helpful for cooling the body quickly.

Even healthy seniors should try to avoid the hottest times of the day, she adds. “Do things early in the morning and take plenty of shade or air-conditioning breaks.

“You need to respect the heat.”

Candy Sagon writes on health issues for the Bulletin.