The contribution of assets to adaptation to extreme temperatures among older adults

Exploring interconnections: A comprehensive multi-country analysis of climate change, energy demand, long-term care, and health of older adults

Challenges faced by many countries are energy insecurity, climate change, and the health and long-term care of growing numbers of older people. These challenges are increasingly intersecting with rising energy prices, aging populations, and an increased frequency and intensity of extreme climate events. This paper gives a deeper understanding of the current and predicted interconnections among these challenges through narrative-driven content and thematic analysis from workshops with a diverse group of international stakeholders from the Global North and Global South. Narratives emerged highlighting a complex nexus of interconnections and presenting critical action areas. Targeted local and global policies and interventions are needed to alleviate stress on health systems, encourage the integrated uptake of clean energy sources, and uphold social justice across all economies. Professionals can use this work to inform the design and implementation of effective interventions and increase the resilience of older adults by better preparing for systemic risks.

Older adults' occupations in heat waves: A scoping review

BACKGROUND

Heat waves impact the health of older adults, and occupations are important for health. An overview of research focussed on older adults' occupations in heat waves can be useful for occupational therapy practice.

OBJECTIVE

To identify what the literature shows about older adults' experience and performance of, and participation in, occupations in heat waves.

MATERIAL AND METHOD

This scoping review included a literature search in five academic databases, four databases for grey literature, and a manual search. Literature in English regarding older adults 60+ and their occupations in heat waves were eligible.

FINDINGS

Twelve studies were included. Findings showed that older adults adapt their occupations using bodily, environmental, and social interaction strategies and by changing their daily routines. Personal, environmental, social, and economic factors facilitate and maintain occupations in heat waves.

CONCLUSION

Older adults adapt their occupations in heat waves and different factors impact how they can be adapted. Future research is needed to explore how older adults experience their occupations in heat waves, and to deepen the knowledge about their heat-adaptive strategies.

SIGNIFICANCE

The findings support the role of occupational therapists in the design and practice of interventions managing the impact of heat waves in daily life.

Heat waves and adaptation: A global systematic review

BACKGROUND

Given the increasing trend of global warming and extreme weather conditions, including heat waves and its effects on health, the present study was done to investigate adaptive behaviors of communities in the world for combating heat waves.

METHOD

ology: In this systematic review, out of 1529 results, 57 relevant and authoritative English papers on adaptation to heat waves hazard were extracted and evaluated using valid keywords from valid databases (PubMed, WOS, EMBASE, and Scopus). In addition, multiple screening steps were done and then, the selected papers were qualitatively assessed. Evaluation results were summarized using an Extraction Table.

RESULTS

In this paper, the adaptive behaviors for combating heat waves hazard were summarized into 11 categories: Education and awareness raising, Adaptation of critical infrastructure, Governments measures, Health-related measures, Application of early warning system, Protective behaviors in workplace, Physical condition, Adaptive individual behaviors, Design and architecture of the building, Green infrastructure (green cover), and Urban design.

CONCLUSION

The findings of this study showed that community actions have significant effects on adaptation to heat wave. Therefore, for reducing heat wave-related negative health effects and vulnerability, more attention should be paid to the above-mentioned actions for mitigation, preparation, and responding regarding heat waves.

PROSPERO REGISTRATION NUMBER

CRD42021257747.

A Descriptive Qualitative Study of Older Persons and Family Experiences with Extreme Weather Conditions in Northern Thailand

Extreme weather can cause ill health in older persons due to a direct thermal effect on the body's thermoregulation and difficulties in maintaining a healthy lifestyle and accessing the health services they need. To understand experiences in relation to their exposures to extreme weather and how they responded to such weather conditions, including cold snaps, heat and air pollution in northern Thai communities, a descriptive qualitative study was conducted to uncover details and the essence of perspectives and experiences of older persons and family members. Three focus group discussions with 15 older persons and 15 family members occurred in three communities in Chiang Rai, a northern province of Thailand. Thematic analysis was performed. Experiences of older persons and families in relation to extreme weather conditions were described in five themes: local actions against weather changes, the double challenges, awareness and reactions to weather changes, protective and comfortable living environments, and mitigation of the impacts of weather conditions. Seasonal adaptability was key for older persons to stay safe and healthy during extreme weather changes. Heat, cold snaps, and air pollution made health and daily living routine maintenance among older persons challenging, especially among those with declining health. Older persons and families employed predictive and adaptive strategies to avoid and minimise extreme weather impacts and maximise their comfort and optimal living.

Short-term effect of ambient temperature and ambient temperature changes on the risk of warts outpatient visits in Hefei, China: a retrospective time-series study

Concerns are growing about the adverse health effects of ambient temperature and ambient temperature changes. However, the association between ambient temperature and ambient temperature changes on the risk of warts outpatient visits is poorly understood. Our study used the distributed lag non-linear model (DLNM) aimed to evaluate the association between ambient temperature, ambient temperature changes (including temperature change between neighboring days (TCN) and diurnal temperature range (DTR)), and warts outpatient visits. We also performed subgroup analyses in order to find susceptible populations by gender and age groups. The maximum relative risk (RR) of low ambient temperature (0 °C) for warts outpatient visits was 1.117 (95% CI: 1.041-1.198, lag 04 days), and the maximum RR of high ambient temperature (32 °C) for warts outpatient visits was 1.318 (95% CI: 1.083-1.605, lag 07 days). The large temperature drop (TCN =  - 3 °C) decreased the risk of warts visits, with the lowest RR value at the cumulative exposure of lag 7 days (RR = 0.888, 95% CI: 0.822-0.959), and the large temperature rise (TCN = 2 °C) increased the risk of warts visits, with the highest RR value at the cumulative exposure of lag 7 days (RR = 1.080, 95% CI: 1.022-1.142). Overall, both low and high ambient temperatures and large temperature rise can increase the risk of warts visits, while large temperature drop is a protective factor for warts visits. However, we did not find any association between DTR and warts visits. Furthermore, subgroup analyses showed that males and the young (0-17 years old) were more sensitive to low and high ambient temperatures, and the elderly (≥ 65 years old) were more susceptible to TCN. The results may provide valuable evidence for reducing the disease burden of warts in the future.

Elderly People's Perceptions of Heat Stress and Adaptation to Heat: An Interview Study

Objectives: Heatwaves are having a disproportionate impact on the elderly population, as demonstrated by pronounced mortality and morbidity. The present study aimed to explore elders’ subjective experiences of heat impacts and adaptive strategies. Methods: Semi-structured interviews with 19 elderly Swedes were conducted, focusing on their experiences of the extremely hot summer of 2018. Results: Most informants suffered during the heatwave, although some found it pleasant. The readiness to implement adaptive measures was generally high among the healthiest, who were able to avoid excessive heat and adjust their daily routines. In contrast, those highly dependent on care from others had limited options for avoiding the heat, and little capacity to take up adaptive measures. Discussion: With heat becoming an increasing problem, it is important to adjust elderly care so that the most vulnerable elderly people can avoid excessive heat exposure.

General and specified vulnerability to extreme temperatures among older adults

Extreme temperatures pose significant risks to human health and well-being. Older adults are particularly at risk and their susceptibility is a function of vulnerability to general daily life circumstances and to specified events or threats. For the first time, this paper develops a combined general and specified approach to understand the determinants of vulnerability. The findings show that most participants exhibit high levels of heat-related vulnerability, followed by cold-related vulnerability and lastly, general vulnerability. General vulnerability was shown to be primarily shaped by financial, physical and social assets. Whilst, specified vulnerability was found to be mainly shaped by human, physical and placed based assets. Such findings present opportunities to focus on the types of assets that contribute to reducing vulnerability. These findings also suggest that the role assets play in shaping vulnerability must be attended to if we are to fully understand and effectively implement strategies to reduce vulnerability.

Thermoregulation in the Aging Population and Practical Strategies to Overcome a Warmer Tomorrow

As global temperatures continue to rise, improving thermal tolerance in the aged population is crucial to counteract age-associated impairments in thermoregulatory function. Impairments in reflex cutaneous vasodilation and sweating response can augment the vulnerability of older adults to heat-related injuries following exposure to heat stress. Mechanisms underlying a compromised cutaneous vasodilation are suggested to include reduced sympathetic neural drive, diminished cholinergic co-transmitter contribution, and altered second messenger signaling events. On the other hand, impairments in sweating response are ascribed to reduced sweat gland cholinergic sensitivity and altered cyclooxygenase and nitric oxide signaling. Several practical mitigation strategies such as exercise, passive heating, and behavioral adaptations are proposed as means to overcome heat stress and improve thermal tolerance in the aged. Aerobic exercise training is shown to be amongst the most effective ways to enhance thermoregulatory function. However, in elderly with limited exercise capability due to chronic diseases and mobility issues, passive heating can serve as a functional alternative as it has been shown to confer similar benefits to that of exercise training. Supplementary to exercise training and passive heating, behavioral adaptations can be applied to further enhance the heat-preparedness of the aged.