Why older adults face a higher risk of heat-related illnesses
August 25, 2026
North Texans have faced another long, hot summer, with triple-digit temperatures reaching near-record highs in August. As heat advisories persist, the risk of heat-related illnesses such as heat exhaustion and heat stroke increases – especially for older adults.
As we age, our bodies have a tougher time regulating their temperature. You may notice after age 60 that you get overheated faster than you used to and that it takes longer for you to cool down. Older adults reach higher core temperatures at the same level of heat exposure as younger adults due to multiple factors, such as a combination of normal aging changes, chronic diseases, and medications.
Several factors can contribute to this:
- Older adults sweat less due to changes in the skin and the structure of the sweat glands, making it harder to release excess heat.
- Skin gets thinner as fat redistributes with age, making it easier for heat to affect the body.
- Some older adults get dehydrated easily due to reduced thirst sensation, limiting fluids to avoid multiple bathroom trips, or taking diuretic medications (water pills).
Without proper care, heat exhaustion or heat stroke can lead to severe illness, hospitalization, or even death. Fortunately, many causes of heat-related illness can be avoided with planning and communication. The first step is to know how to identify the warning signs.
What are the signs of heat-related illness?
There are two general categories of heat-related illness: heat exhaustion and heat stroke.
Heat exhaustion
Heat exhaustion occurs when the body gets overheated and has trouble cooling down. Heavy sweating can be one sign, but since older adults sweat less, they’re more likely to notice these signs instead:
- Dehydration
- Dizziness
- Fatigue
- Feeling generally unwell
- Nausea
- Weakness
If someone shows signs of heat exhaustion, move them to a cool, air-conditioned location. Encourage them to drink fluids if they can do so safely. If symptoms do not improve within a few minutes or if they get worse, seek medical care. Some older adults with heat exhaustion may need intravenous (IV) fluids to rehydrate and cool down.
Heat stroke
Heat stroke is more serious and requires emergency medical care. The primary symptom is a fever over 104 degrees Fahrenheit (or 40 degrees Celsius). Other symptoms are similar to signs of a stroke and may include:
- Confusion
- Fainting
- Loss of consciousness
- Seizures
- Slurred speech
Seek emergency medical care immediately for anyone who has these symptoms. These can be signs that the brain is affected by extreme heat or another neurological trauma, such as a concussion or stroke. Older adults with heat stroke symptoms may need to be hospitalized for close monitoring of their brain, heart, and kidney function.
Tips to prevent heat-related illness
1. Stay hydrated
Drinking water regularly is one of the best ways to avoid heat stroke or heat exhaustion. Like most body systems, thirst signals slow as we age. That means you may already be in the early stages of dehydration before you feel like you need to drink water.
In our geriatric medicine clinic, we often tell patients to think of water like medicine. Build drinking water into your routine by setting reminders on your clock or phone, just like you would for taking prescriptions or going to appointments.
Aim for six to eight cups of water each day unless your doctor has recommended limiting fluids. Make the flavor more interesting by adding slices of lemon, oranges, or mint if these are safe for you to consume. Avoid drinking alcohol and excess caffeine – both are natural diuretics, which means they can increase your risk of dehydration.
Find a cool place in your community
If you or a loved one struggles to keep the home cool, contact your local city government or Area Agency on Aging to learn what programs may be available. Several North Texas communities offer support during heat waves, including:
• Utility assistance programs such as the State of Texas Comprehensive Energy Assistance Program and Texas Neighborhood Services.
• Cooling centers operated by the City of Dallas, including libraries, recreation centers, and community organizations.
• Organizations that connect seniors with local resources, such as Area Agencies on Aging or Aging & Disability Resource Center of Dallas County.
2. Stay indoors when it’s hot out
Keep an eye on the weather. If there is a heat advisory, or if the temperature is climbing into the 80s, 90s, or higher, stay indoors as much as possible. But that doesn’t mean you can’t stay active. Gather friends to walk indoors at a mall or community center or sign up for an indoor fitness class – you’ll get the double benefit of exercise and social interaction, both of which are good for your physical and cognitive health.
If you must go outside on extremely hot days, schedule activities in the early morning when the temperature is lower and there is less direct sunlight. Wear lightweight clothing, a wide-brimmed hat, and sunglasses with UV protection. And don’t forget sunscreen – choose one that blocks UVA and UVB rays, with SPF 30 or higher.
3. Keep your home cool
Budget-conscious older adults may worry about the cost of running their air conditioner during the summer. Using a fan is supposed to help by promoting heat loss through sweat. Unfortunately, because sweat production is impaired in normal aging, the effectiveness of fan use is reduced. Using a fan in air temperatures that are higher than body temperature can worsen overheating because the hot, dry air will increase body heat.
In humid conditions, fan use may be helpful. The maximum safe temperature to use a fan recommended by guidelines is no higher than 95 degrees Fahrenheit (35 degrees Celsius), but this may still be too hot for an older adult to endure for a prolonged time. Instead, try using other methods of cooling such as hydration, cool moisture, and quickly finding a safe location with air conditioning.
Extreme heat can be particularly dangerous for older adults who live alone or have complex health conditions. As winter approaches, many of these adults may face new challenges related to cold weather and indoor temperatures.
Older adults who have difficulty getting to doctor appointments may benefit from enrolling in our Care of the Vulnerable Elderly (COVE) program. Through COVE, aging Texans who meet program criteria can get home visits from a geriatrics care team to help manage chronic conditions and make connections with helpful community resources to improve safety and quality of life at home.
Make a point to check in on loved ones, friends, and neighbors when temperatures become extreme. A quick phone call or visit can make a big difference to their well-being.
We’re all going through these seasons of change together, and keeping an eye out for one another helps us all stay safe and healthy.
To talk with an expert about heat-related illness prevention or care, make an appointment by calling 214-645-8650 or request an appointment online.
