Heat Health Prevention Measures and Adaptation in Older Populations—A Systematic Review

Abstract

The population of older people is increasing at a rapid rate, with those 80 years and older set to triple by 2050. This systematic review aimed to examine older people’s perceptions and behaviours against existing heatwaves prevention measures and systematically categorize and analyse those measures using the Ottawa charter for health promotion framework. Peer-reviewed published literature between 22nd September 2006 and 24th April 2018 was retrieved, according to the PRISMA guidelines, from five different databases. Eighteen articles were finally included. There is a lack of published studies from developing countries. Results were categorized and analysed using the Ottawa charter five action areas. Mitigation strategies from current heat action plans are discussed and gaps are highlighted. A lack of systematic evaluation of heat action plans efficacy was identified. Older people are not demonstrating all recommended preventative measures during heatwaves. Support personnel and health professionals are not being pro-active enough in facilitating prevention of adverse effects from heatwaves. Governments are beginning to implement policy changes, but other recommended support measures outlined in the Ottawa charter are still lacking, and hence require further action. Linkage between specific components of heat action plans and outcomes cannot be ascertained; therefore, more systematic evaluation is needed.

High Temperatures and Cardiovascular-Related Morbidity: A Scoping Review

“…This may be due to physiological changes caused by aging; older individuals experience central cardiovascular strain in addition to reduced capacity to thermoregulate and redistribute blood flow thereby increasing their vulnerability to high temperatures [ 43 ]. Older individuals may also have lower recall rates of heat warnings and confusion related to heat-health risks, which can result in a decreased use of adaptive behaviours [ 45 ]. Additionally, older individuals may experience less physical independence and reduced capacity to adapt their activities to changes in temperatures compared to younger individuals [ 45 ].…”

“…Older individuals may also have lower recall rates of heat warnings and confusion related to heat-health risks, which can result in a decreased use of adaptive behaviours [ 45 ]. Additionally, older individuals may experience less physical independence and reduced capacity to adapt their activities to changes in temperatures compared to younger individuals [ 45 ]. It is important to note that two studies from Quebec, Canada, reported an increased risk of IHD and STEMI hospital admissions among younger age groups, particularly women 45–64 years old and 55 years or younger, respectively [ 36 , 37 ].…”

Trends in heat and cold wave risks for the Italian Trentino Alto-Adige region from 1980 to 2018

“…Our detailed analysis shows where to prioritize risk mitigation measures to 430 reduce the hazard and vulnerability. Measures to mitigate heat in cities include, for example, greening of cities (Alsaad et al, 2022;Taleghani et al, 2019) , while vulnerability could be decreased by improving the social and living conditions of citizens, especially of the elderly who are more vulnerable (Orlando et al, 2021;Poumadère et al, 2005;Vu et al, 2019), particularly in the cities of this region where 435 they are becoming more numerous. If detailed data are available for temperature, exposure and vulnerability indicators, the methodology presented here could be applied to other regions in-and outside Italy to help steer local climate adaptation investments at the city level.…”

Adaptation and Resilience to Planetary Change

“…Physiological adaptation occurs, but only to a point, beyond which people cannot continue to adapt (36). Community adaptation includes early warning systems that enable authorities to advise people of impending extreme heat, public education, mapping to identify vulnerable neighbourhoods, 'buddy' systems for looking in on vulnerable people such as elders living alone, cooling centres, provision of water, rescheduling or cancelling of outdoor activities during hot times of the day, extended hours in public pools, and support for utility bill payments so people are not inhibited from using their air conditioning (37)(38)(39)(40). Longerterm adaptations include the replacement of dark urban surfaces (rooftops and pavements) with lighter colours to reduce the heat island effect and planting of trees for shade.…”