Ronan Factora, M.D
U.S. News & World Report
Summer is in full swing. For most people, it's a great time to be outside. Daytime walks, gardening, exercising and relaxation outdoors are common activities during warm days. All individuals, regardless of age, should be encouraged to reduce sedentary behavior and remain as active as possible; this includes spending time outdoors.
Aging, however, poses challenges related to exposure to hot weather and higher temperatures. The body's ability to regulate its temperature changes during aging and through medical problems that can come with aging. Older individuals often have a reduced ability to feel thirst. This change in sensitivity – coupled with aging's normal reduction in percentage of the body made up of water – increases the likelihood an older person will get dehydrated. Adding in medications meant to help reduce excessive fluid in the body (diuretics such as furosemide and hydrochlorothiazide) can result in real problems for older people.
Older individuals also don't sweat as much as those who are younger. Consequently, it's harder for the body to cool itself when the core temperature rises. Combined with medications that may also impair sweating (such as medications taken for overactive bladder like oxybutynin or tolterodine), the body's ability to cool itself really becomes impaired, and the risk for heat stroke increases.
Both the inability to regulate temperature and a decrease in sweating can contribute to symptoms of lightheadedness and dizziness. In particular, orthostatic hypotension, which is a reduction in blood flow to the brain caused by moving from lying down to standing or sitting, can lead to dizziness and increased risk of a fall. For many seniors, this fall can lead to a fracture. Individuals taking blood pressure medications or men taking medications for an enlarged prostate (such as tamsulosin) may be at higher risk for dizziness-related events.
Here are a few suggestions to prevent complications due to warm weather:
- Drink fluids to prevent dehydration; one way to make sure you are drinking enough is to look at the color of your urine when you go to the bathroom. You want it to be a light, clear amber/yellow color. Darker urine is your body's way of telling you that you should drink more fluids.
- Wear a hat to keep cool if you're spending time in the sun.
- Take breaks and sit down in shaded and air conditioned areas to prevent overheating.
And, watch out for these symptoms, as they may be signs of heat stroke and require immediate medical attention: lightheadedness with change of position; headache; confusion; and reduced sweating.
My general advice is to enjoy the outdoors – one of the best ways to keep active – but be aware of the signs of heat stroke and ways to prevent it.
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