Extreme Heat: Silent Threat to Older Adults
The Silent Threat: Why Extreme Heat is a Growing Danger for Older Adults
Table of Contents
Published August 20, 2025
As temperatures climb globally, a concerning trend emerges: older adults are disproportionately vulnerable to the dangers of extreme heat, and are frequently enough unprepared for prolonged heat events. A complete review of 41 studies,published today in PLOS Climate,reveals a meaningful gap between awareness of the risk and proactive planning. The research, spanning studies conducted from 2010 to 2024, underscores a critical need for increased vigilance and targeted interventions.
Reacting vs. Preparing: A Critical Distinction
The review found that the vast majority of existing research (29 out of 41 studies) centers on how older adults cope *during* heat waves – staying hydrated, seeking cooler environments, and adjusting their activities. Though, alarmingly few studies (only one) specifically examined heat preparedness strategies.This suggests a potentially hazardous lack of foresight, a tendency to rely on past experiences that may no longer be relevant in a rapidly changing climate.
“Risk awareness seems to be quite low among older adults and their caregivers,” notes Fiona Doherty, a former PhD graduate of Ohio State University and now an assistant professor of social work at the University of Tennessee.
This lack of preparation is notably concerning given demographic shifts. by 2050, the number of people aged 65 and over is projected to exceed the number of children under five, making this an increasingly urgent public health issue.
The “Silent Killer” and Changing Realities
The dangers of extreme heat are often underestimated. As Smitha Rao, assistant professor of social work at The Ohio State University, powerfully states, “Extreme heat is not often viewed as a weather disaster like hurricanes or floods, but it should be. It is not something that is visible, which is why it is often called the ‘silent killer.'”
The researchers emphasize that what worked in the past to mitigate heat stress is no longer sufficient. Record-breaking temperatures in 2023 and 2024, and projections of continued warming, demand a reassessment of traditional coping mechanisms. Furthermore, the human body changes with age, and these changes can exacerbate vulnerability to heat.
“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 thay are taking or medical conditions they have may make them prone to overheating,” Rao explains. Tragically, many heat-related deaths among older adults occur in their homes, often at night, indicating a lack of awareness of the escalating danger.
Beyond Individual Action: The Role of Community and Policy
While individual coping strategies are important, a broader approach is needed. The review highlighted that only seven studies focused on service delivery to older adults during extreme weather events, and even fewer (the smallest number in the review) addressed policy interventions. This imbalance underscores the need for more proactive and systemic solutions.
Effective interventions require engaging older adults to understand their specific needs and tailoring solutions accordingly. This could include home weatherization programs, access to affordable cooling options, and improved outreach to vulnerable populations.
Promising examples are already emerging. In Columbus, Ohio, the Central Ohio Transit Authority recently implemented a policy of providing free bus rides during extreme heat events, ensuring access to cooling centers for all residents. “It is good to see policy changes like this that are responding to what our new normal looks like,” says Marisa Sheldon, director of the Age-Amiable Innovation Center at Ohio State’s College of Social Work.
Another study, published in Environmental Communication, explored how older adults receive and trust details about extreme weather, particularly those from diverse cultural and linguistic backgrounds. The findings emphasized the critical importance of building relationships and trust between individuals and community agencies.
Building Resilience Through Connection
“One compelling finding from both studies was the importance of relationship building,” Doherty explains. “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.”