Older adults more susceptible to hypothermia


Dear Doctors: Is it true that it’s dangerous for older adults to spend time outside in cold weather? Why would that be? I’m 73 years old and have enjoyed cross-country skiing this winter. It does get cold, but I’m careful. My daughter wants me to stop because she’s worried about hypothermia.

Dear Reader: Cold weather can be hazardous for anyone. However, it does pose additional risks to older adults. This is due to some of the physical changes associated with aging, which can make it more difficult to generate and retain body heat than when a person was younger.

One factor is that the layer of fat just beneath the skin, which helps to conserve body heat, becomes thinner in older adults. Another is less-efficient blood flow, which occurs due to the decline in elasticity in the veins and arteries as we age. Blood absorbs and distributes heat as it circulates through the body, and less-efficient circulation makes it harder to stay warm. Certain health conditions -- such as cardiovascular disease, kidney disease, thyroid problems and diabetes -- can increase someone’s sensitivity to cold. So can some medications, such as beta blockers and calcium channel blockers. These meds, which are used to manage blood pressure, can reduce blood flow to the extremities.

At the same time, it can be more difficult for older adults to recognize the body’s signals that it is becoming too cold. The result is that hypothermia, which is when the body loses heat at a faster rate than it can generate it, becomes a real possibility. Hypothermia affects not only the body, but also the brain. The muddled or disordered thinking that occurs during hypothermia can not only affect decision-making, it can also prevent the person from even realizing they are in danger.

Symptoms of hypothermia in adults include uncontrollable shivering, slow or shallow breathing, weak pulse, loss of precise motion when using hands and fingers, exhaustion, drowsiness, slurred speech and confusion. This drop in body temperature adversely affects the heart, nervous system and organs, and it can lead to death.

Elizabeth Ko, MD and Eve Glazier, MD

Hypothermia is a medical emergency and requires immediate medical attention. While waiting for help to arrive, get the person into a warm room, remove wet clothing and wrap them in a dry blanket. Some people with hypothermia need help with rewarming. This can include the use of warm nonalcoholic drinks, a heating blanket or heating pad on a moderate setting wrapped around the torso and warm packs wrapped in fabric. Never apply these directly to the skin. If nothing else is available, use your own body heat.

Avoid hypothermia by dressing for the weather. Wear an inner layer that wicks away sweat from the body, a middle layer to insulate and an outer layer that repels moisture. Avoid cotton, which traps moisture and leads to becoming chilled. Have a hat, scarf and gloves, and wear warm, weatherproof footwear. Remove layers as you warm up with exercise, and add them back as soon as you feel cold. Ease your daughter’s mind by always bringing along a cellphone, sticking to a set path and keeping your outings short.

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