Summer heat in Texas can be more than just miserable - it can be dangerous. When the mercury climbs past 90, everyone's at risk. Not only can make you sick, it can also kill you. Each year, about 50 Texans die due to the summer heat.

Especially at risk when the temps are high are the elderly.  In a heat wave that killed 522 in Chicago in 1995, 73 percent of the deaths were people 65 or older.

One reason the elderly are particularly susceptible to heatstroke and death is because aging reduces the body's ability to regulate body temperature under hot and humid conditions. Age blunts normal thirst mechanism, and chronic illnesses such as heart disease and diabetes make the elderly more vulnerable to heat-related injury, as do increased fluid losses due to the side effects of medications such as diuretics.

What is heatstroke?

Heatstroke is a life-threatening medical emergency that results from the accumulation of body heat. It can develop rapidly and requires immediate intensive treatment. If a person becomes dehydrated and can't sweat enough to maintain normal body temperature, the body temperature can rise rapidly to dangerously high levels, causing heatstroke. As the sweating mechanism fails and the body is unable to cool down properly, body temperature may rise to 106F or higher within 10 to 15 minutes.

Heatstroke should not be confused with heat exhaustion which is a condition that can progress to heatstroke. Warning signs of heat exhaustion include the following: paleness, muscle cramps, fatigue, weakness, dizziness, headache, nausea or vomiting, and fainting. The skin may be cool and moist; sweating may or may not occur. The pulse will be fast and weak, and breathing will be fast and shallow. Untreated, heat exhaustion can lead to heatstroke.

Why the concerns about heatstroke in the elderly?

Elderly persons begin to sweat at higher body temperatures and less effectively than younger persons. The inability to regulate body temperature through the normal sweating and evaporation mechanism contributes to the vulnerability of older persons to heatstroke.

Heatstroke not treated immediately may lead to death. Of all persons who die of heatstroke, about 80 percent are age 50 and older. Deaths attributed to diabetes, lung disease, and hypertension increase by more than 50 percent during heat waves; thus, the risk of hyperthermia-related death may depend as much on the severity of the person's chronic illnesses as on severity of heat stress.

Why are the elderly so susceptible to heatstroke?

Heatstroke occurs 12 to 13 times more frequently in persons 65 years or older than in younger persons. Several risk factors make the elderly more susceptible to heatstroke; they include:

• Compromised body temperature control mechanism
• Medical disorders such as heart diseases, diabetes, and chronic obstructive pulmonary disease
• Certain medications including diuretics, antidepressants, antipsychotics, sedatives, and antihistamines
• Mental illness
• Alcohol use
• Dehydration
• Impaired self-care ability
• Unavailability of air-conditioning

What are the signs and symptoms of heatstroke in elderly residents who may already be experiencing it? The warning signs of heatstroke vary but may include an extremely high body temperature (above 103?F); red, hot, and dry skin (with little or no sweating); rapid, strong pulse initially, then weak and rapid pulse; throbbing headache; dizziness; nausea; shortness of breath; confusion; unconsciousness; and in extreme cases, seizures and coma.

What should be done if someone is suffering from heatstroke? Heatstroke is a medical emergency, and lifesaving measures should be started immediately. The first steps are to call 911 and then to reduce the body's temperature as rapidly as possible. A person who can't be taken to a hospital immediately should be wrapped in wet bedding or clothing, immersed in a cool bathtub, or even cooled with ice while awaiting transport. Give nothing by mouth to the person. The person should then be transferred to the hospital immediately.[3]

How can heatstroke be prevented?

• When possible, stay in an air-conditioned environment.
• Drink plenty of water or nonalcoholic fluids even if you don't feel thirsty.
• Dress for the heat. Wear lightweight, light-colored clothing. Light colors will reflect away some of the sun's energy. It is also a good idea to wear hats or to use an umbrella.
• Eat small meals and eat more often. Avoid high-protein foods, which increase metabolic heat.
• Slow down. Avoid strenuous activity. If you must do strenuous activity, do it during the coolest part of the day, which is usually between 4 and 7 a.m.
• Be a good neighbor. During heat waves, check in on elderly residents in your neighborhood and those who do not have air conditioning.
• Don't get too much sun.  Slow down.  Strenuous activities should be reduced, eliminated, or rescheduled to the coolest time of the day. Individuals at risk should stay in the coolest available place, not necessarily indoors.

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