Heat waves can be fatal for elderly; Rising temperatures put millions at risk

In April and May 2024, a deadly heat wave swept across large parts of Asia, leaving a trail of suffering and tragedy. As temperatures soared past 110°F (43.3°C) in India on May 7, politicians on the campaign trail, local news announcers, and voters waiting in long lines all blacked out due to the oppressive heat. From Japan in the north to the Philippines in the south, the relentless heat disrupted everyday life.

In Cambodia, students and teachers were sent home from school as their handheld fans proved inadequate against the stifling heat and humidity in poorly ventilated classrooms. Meanwhile, farmers in Thailand watched their crops wither, and livestock perished under the punishing sun. Tragically, hundreds of people lost their lives due to the extreme temperatures.

This heat wave is not an isolated incident. Across the globe, extreme heat has become a recurring menace.

In the southwestern United States, a weekslong heat wave in 2023 turned Phoenix into what locals described as “hell on earth.” For 31 consecutive days, temperatures soared to 110°F (43.3°C) or higher. Simultaneously, Europe experienced unprecedented high temperatures that claimed hundreds of lives and fueled devastating wildfires in Greece.

Vulnerability of Older Adults

Regardless of where or when heat waves strike, one constant remains: older adults are the most vulnerable. Unfortunately, this crisis is set to worsen in the coming years due to two critical factors.

Firstly, global temperatures are hotter than ever. The nine-year period from 2015 to 2023 witnessed the highest average temperatures since record-keeping began in 1880. Secondly, the world’s population is aging rapidly. By 2050, the number of people aged 60 and older will double to nearly 2.1 billion, constituting 21% of the global population (up from the current 13%).

These combined forces mean that an ever-growing number of vulnerable older adults will face intensifying heat. Our projections indicate that by 2050, over 23% of the world’s population aged 69 and older will reside in regions where peak temperatures routinely exceed 99.5°F (37.5°C), compared to the current 14%. This translates to approximately 250 million additional older adults exposed to dangerously high temperatures.

Mapping this data reveals that most of these older adults live in lower- and middle-income countries, where services are insufficient, access to electricity and cooling appliances is limited, and safe water is scarce. In historically cooler regions like North America and Europe, rising temperatures will primarily drive older adults’ heat exposure. Conversely, in historically hotter regions such as Asia, Africa, and South America, population growth and increased longevity will expose steeply rising numbers of older adults to heat-related risks.

The impact of extreme heat on older adults is particularly severe. Their age-related health conditions—such as heart, lung, and kidney diseases—are exacerbated by high temperatures. Unlike younger individuals, older people don’t sweat as much, making it harder for their bodies to cool down during heat spikes. Common prescription medications, like anticholinergics, further reduce their capacity to sweat.

Dehydration is a significant concern, especially in regions lacking access to safe drinking water. Poor air quality compounds the problem, particularly for those with lung issues like chronic obstructive pulmonary disease (COPD). Even temperatures as low as 80°F (26.7°C) can pose risks for older adults, and humidity exacerbates the danger.

Nighttime heat is especially harmful for those without air conditioning. Restful sleep occurs between 68°F and 77°F (20°C and 25°C), but sleep quality diminishes as temperatures rise. Medications lose effectiveness when stored in places warmer than 77°F (25°C).

Emotionally, stifling heat waves take a toll. Older adults stuck indoors may feel bored, depressed, and isolated. Cognitive impairments can lead to underestimating heat dangers or misunderstanding advisories. Mobility limitations and lack of transportation prevent easy access to cooling centers or nearby green spaces.

In low- and middle-income nations, systemic cooling poverty exacerbates these threats. Substandard housing and limited healthcare further compound the risks.

Actions Needed to Protect Aging Populations

To address this crisis, policymakers must cut greenhouse gas emissions, develop effective heat protection plans, and tailor efforts to each region’s needs. Investments in early warning systems, public support such as cooling centers, and expanded power grids are essential.

The World Health Organization and Pan American Health Organization emphasize the urgency of preparing communities to handle rising heat and protect aging populations. Researchers, practitioners, and policymakers must heed this call to save lives.

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