Heat Waves: A Lethal Threat to Seniors

The deadly heatwave that gripped large regions of Asia in April and May 2024 left a lasting imprint on the nations affected. With temperatures soaring past 110 degrees Fahrenheit (43.3 Celsius) in India, there were reports of politicians campaigning, local news announcers, and voters waiting in long lines to pass out due to the oppressive heat. 
 
This was not an isolated event but part of a larger pattern affecting countries from as far north as Japan to as far south as the Philippines. The relentless heat disrupted everyday life with students and teachers sent home from schools in Cambodia, their handheld fans providing little relief against the stifling humidity inside poorly ventilated classrooms. Farmers in Thailand watched helplessly as their crops wilted under the punishing sun while livestock perished, leading to significant economic losses. 
 
These extreme weather conditions have become increasingly common worldwide, with record-breaking high temperatures being recorded over recent years. A glaring example was seen during a weekslong heat wave across the southwestern United States in 2023 when Phoenix experienced temperatures hitting 110 F or higher for an astounding 31 straight days—aptly described by locals as "hell on earth." Europe faced similar trials, with exceptionally high temperatures contributing to the wildfires that ravaged Greece. 
 
There are two main factors driving these alarming trends: firstly, global warming has led to rising average temperatures—between 2015 and 2023, we saw some of the highest averages since records began back in 1880; secondly, our world population is aging rapidly—by mid-century estimates suggest that those aged sixty or older will make up around 21 percent globally compared with 13 percent today. 
 
Our projections indicate that if current trends continue unabated, then by mid-century, more than twenty-three percent of people aged sixty-nine years or older will be living in regions where peak summer-time temperatures regularly exceed potentially lethal levels, compared with just fourteen percent now, which equates to nearly a quarter-billion additional vulnerable elderly individuals at risk from dangerously high temperatures. 
 
Most of these older adults live in lower- and middle-income countries with limited access to essential services such as electricity, cooling appliances, or safe drinking water. This exposure is intensified further for those living in historically cooler regions such as North America and Europe, where rising temperatures are becoming the norm. Conversely, in historically hotter regions like Asia, Africa, and South America, it's population growth combined with increasing longevity that will see a steep rise in the numbers of older people exposed to extreme heat-related risks. 
 
It’s crucial for policymakers, communities, families, and elderly individuals themselves to understand these risks, given their particular vulnerability to heat extremes. High temperatures can exacerbate common age-related health conditions such as heart disease, lung disease, and kidney problems while also causing delirium due to reduced capacity for sweating, which aids body temperature regulation, among the elderly. 
 
Extreme heat can cause dehydration and worsen side-effects from certain prescription medications like diuretics or beta-blockers, thus increasing the risk of falls or injury. Poor air quality compounds breathing difficulties, especially for those already suffering from chronic obstructive pulmonary disease (COPD). Even relatively low daytime temperatures around 80 F (26.7 C) pose significant danger, particularly if accompanied by high humidity levels. At night, this threat persists, especially where there is no access to effective air conditioning, making restful sleep difficult and thereby affecting overall mood and cognition during waking hours. 
 
These issues are magnified further amidst stifling heat waves when being confined indoors leads to not just physical but also emotional distress through feelings of isolation or depression, particularly among cognitively impaired individuals who may lack understanding about the potential dangers posed by extreme heat situations. 
 
Without easy access, either physically due to transport limitations or because local amenities are simply too far away, public cooling centers offer little respite, nor do nearby "green/blue" spaces like parks and lakes provide natural cooling effects. These challenges become even more pronounced within poorer nations where substandard housing coupled with inadequate healthcare provision combine, creating what we term "systemic cooling poverty.". 
 
To address these challenges effectively, it requires coordinated efforts from policymakers to reduce greenhouse gas emissions—the primary driver behind global warming—and develop robust plans for protecting elderly individuals from heat risks. Strategies need to be regionally specific, with wealthier municipalities investing in early warning systems and ride services for transporting people to cooling centers and hospitals, as well as expanding power grids to accommodate increased demand for air conditioning. 
 
In contrast, regions characterized by substandard housing, limited access to clean water, or lacking public support mechanisms such as cooling centers require significant changes, which could include improving healthcare provision, reducing air pollution levels, or providing better quality housing, all of which necessitate substantial investment that many countries may struggle to afford. 
 
The World Health Organization and the Pan American Health Organization have warned that this decade will be critical in preparing communities globally for rising temperatures and associated risks affecting aging populations. By heeding their call, researchers, practitioners, and policymakers can work together towards saving lives under increasingly challenging climatic conditions.