Extreme heat is leaving older adults dangerously unprepared

Extreme heat is creeping into more of our lives every year. Summers are hotter, heat waves last longer, and nights don’t cool the way they once did. Yet many older adults don’t see heat as a threat, and even fewer prepare for it in advance.

A new review of more than 40 studies shows that this lack of awareness could have deadly consequences.

The new research analyzed 41 studies worldwide between 2010 and 2024. Most of them – 29 in total – looked at coping strategies during heat waves, such as staying hydrated or moving to cooler spaces. Only one study focused on actual preparedness before extreme weather arrives.

“Extreme heat is not often viewed as a weather disaster like hurricanes or floods, but it should be,” said Professor Smitha Rao of The Ohio State University. “It is not something that is visible, which is why it is often called the ‘silent killer.’”

Why the issue matters now

Heat doesn’t feel the same at 75 as it does at 25. As people age, their bodies lose some ability to regulate temperature.

Medical conditions and medications can make overheating worse, and dehydration happens more quickly. Many older adults don’t notice the danger until it’s too late, often while at home or even during the night.

That risk is growing more urgent as older adults become one of the fastest-growing age groups. By 2050, people 65 and older will outnumber children under five.

This demographic shift coincides with climate change bringing record-breaking heat, with 2023 and 2024 among the hottest years and temperatures still rising.

“We tend to react based on past experiences in our lives and the reality has changed,” said Professor Holly Dabelko-Schoeny. “The things that worked in the past to deal with heat waves are not going to work in this new reality.”

The role of health and medications

The danger isn’t just outside. Many heat-related deaths occur in people’s own homes. Older adults and their caregivers may not realize that certain medical conditions or medications increase vulnerability.

As bodies age, the natural ability to regulate temperature weakens. That means what once felt like a tolerable summer evening could now be life-threatening.

“We may not realize that our bodies’ reactions to heat changes as we age, and older adults and their caregivers may not realize that some of the medicines they are taking or medical conditions they have may make them prone to overheating,” Rao said.

Gaps in service and policy

Beyond individual coping strategies, only seven studies in the review looked at how services are delivered during extreme heat. Many programs put more effort into protecting against extreme cold than against heat, showing how unbalanced the awareness remains.

The fewest studies explored policies to safeguard older adults, even though that could make the biggest difference.

Changes in local policies show what’s possible. In Columbus, the Central Ohio Transit Authority now makes buses free during extreme heat events. That allows anyone, young or old, to travel without cost to cooling centers.

“It is good to see policy changes like this that are responding to what our new normal looks like,” said Marisa Sheldon, director of the Age-Friendly Innovation Center at Ohio State’s College of Social Work.

The role of relationships

Preparedness isn’t only about air conditioning or public transport. Relationships matter. In a related article in the journal Environmental Communication, researchers found that older adults’ sources of information – and the trust they place in them – are key to survival.

“One compelling finding from both studies was the importance of relationship building,” said co-author Fiona Doherty, now an assistant professor of social work at the University of Tennessee.

“Not only connecting neighbors, but also learning what information sources older adults trust and building trust between individuals and community agencies so that community members follow expert guidance and change their behavior when necessary.”

Facing the future of heat

As the world heats up, the risks for older adults grow sharper. Heat isn’t dramatic like a hurricane, but it is just as dangerous.

Preparing homes, creating clear public policies, and building stronger community networks may save lives.

What once worked may no longer be enough. The challenge now is to change how we think about heat – and to make sure no one is left unprepared.

The full study was published in the journal PLOS Climate.

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