Heat Tolerance, Thermoregulation and Ageing

Older individuals, regardless of how one classifies ‘old’, are the most rapidly growing portion of the population. Statistics from heat waves and other morbidity-mortality data strongly suggest that older persons are at greater risk of developing life-threatening manifestations of heat stress such as heat stroke. Most laboratory studies have found that ageing is associated with decreased heat tolerance and alterations in thermoregulatory effector responses. What is not so clear is the role of ageing per se in this decreased heat tolerance (as opposed to some concomitant functional decline, e.g. decreasing V̇O_2max, which accompanies ageing across a population). Studies have shown decrements in resting heat tolerance and responses to thermal transients in older adults. With exercise in warm environments, most research has focused on the sweating response and it appears that whether or not sweating rate declines in the elderly is dependent upon the environment studied. In hot dry environments, older persons (of both sexes) consistently secrete sweat at a lower rate than their younger counterparts. However, as humidity of the environment increases, this difference tends to disappear. A key issue which deserves further attention is that of hydration in the elderly, both in terms of body water content and compartmentalisation, and of skin water content. Finally, ageing is often accompanied by other conditions (e.g. hypertension, diabetes, cardiovascular insufficiencies, long term therapeutic drug modalities) which further affect heat tolerance and thermoregulation.