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THOSE DARK SPOTS IN YOUR VISION? THEY'RE NOT "HARMLESS."



 

 






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A Moderate Heat Wave Is Not Mild for Older Bodies A Lancet Planetary Health
trial found three days of 34°C heat raised older adults' core temperature,
heart rate and kidney stress markers.




The Capital Brief October 03
Climate & Health Edition
A Moderate Heat Wave Is Not Mild for Older Bodies


Heat warnings usually focus on extreme temperatures. A new trial suggests that
for older adults, even a moderate heat wave puts measurable strain on the body.
Researchers at the University of Ottawa published the study in The Lancet
Planetary Health on September 30. In a climate chamber, 18 adults aged 67 to 84
each spent three days in a simulated heat wave, 34°C during the day and 26°C at
night, and, on a separate occasion, three days at a constant 26°C. The design
let each person serve as their own comparison, and researchers tracked core
temperature, heart function, blood pressure, blood markers of organ stress,
balance and attention. During the heat wave, daily peak core body temperature
was 0.4°C higher on average, and it rose again every day rather than adapting.
Heart rate was higher, blood pressure on standing dropped more, and markers of
kidney and gut stress increased. Balance and attention were also worse. The
study was small and conducted in healthy volunteers in a controlled chamber,
without the fans, cool showers or air conditioning people might use at home. It
measured physiological strain, not heat illness or hospital admissions. The
useful idea is that protection from heat should start at moderate temperatures
for older adults, not only during extreme events. This edition explores the
evidence, not individual medical advice. Signs of heat illness, such as
confusion, fainting or a very high body temperature, require emergency care.

01 Why older adults are more vulnerable
As people age, the body becomes less efficient at shedding heat. Sweating
declines, and the ability to send blood to the skin to release heat is reduced.
The heart has to work harder to cool the body, which can strain people with
heart disease. Many common medicines, including some for blood pressure and
mood, can affect fluid balance or heat tolerance. Older adults may also feel
thirst less strongly and may not notice they are overheating. Heat waves are
consistently associated with increases in deaths and hospital visits among
older people. Understanding the physiology helps explain why.

02 How the trial was designed
Participants were recruited from the Ottawa-Gatineau region, with a median age
of 74 and an equal number of women and men. Each completed both conditions in
random order: three days of simulated heat wave and three days at 26°C.
Humidity was held at 45%, and participants remained in the chamber with limited
physical activity. Researchers measured core temperature continuously and
collected heart, blood pressure, blood, balance and cognitive data. The
crossover design reduces the influence of differences between people, because
each person is compared with themselves. The trial was funded by Health Canada
and the Canadian Institutes of Health Research, and the authors reported no
competing interests. No adverse events occurred during the trial.

03 Body temperature stayed high
Daily peak core temperature averaged 37.8°C during the heat wave, compared
with 37.4°C in the control condition. The difference of 0.4°C was consistent
and statistically significant. Importantly, the elevation recurred each day.
Participants did not adapt over the three days. Warm nights at 26°C did not
provide enough relief to reset the body for the next day. A rise of less than
half a degree may sound small, but it reflects sustained strain on cooling
systems. In real heat waves lasting longer, or with higher temperatures, that
strain could accumulate. The finding supports cooling strategies that address
both daytime heat and warm nights.

04 The heart and blood pressure
Heart rate was about 5 beats per minute higher on average during the heat
wave, and about 8 beats higher at the end of the day. Blood pressure dropped
substantially more when participants stood up, by about 27 millimeters of
mercury systolic in the heat. That kind of drop can cause dizziness or
lightheadedness, which may raise the risk of falls. Measures of heart rhythm
variability suggested reduced control of the heart by the nervous system. These
changes indicate the cardiovascular system was working harder to manage heat.
For people with heart disease, that additional workload can be risky. The study
did not measure heart attacks or other clinical events.

05 Kidneys, gut, balance and attention
A blood marker of kidney stress, NGAL, rose during the heat wave and remained
elevated the next morning. A marker of gut injury, I-FABP, also increased.
Balance worsened, with lower scores on a standing balance test. Attention,
measured by a cognitive test, declined on the second and third days of heat.
Participants drank more fluids in the heat, but their overall fluid balance did
not differ between conditions. These findings suggest heat affects multiple
body systems, not only temperature regulation. Short-term biomarker changes do
not prove lasting damage, but they signal stress.

06 Study limits
With only 18 participants, the study is small, and results may not apply to
everyone. Participants were healthy enough to complete a chamber study, so the
frailest older adults were likely not included. They could not use personal
cooling strategies such as fans, cool showers or air conditioning. Chamber
conditions were constant, unlike real weather, and physical activity was
restricted. The trial measured physiological and biomarker changes, not heat
illness, hospitalizations or deaths. Race and ethnicity data were not collected.
These limits make the findings a strong signal, not a precise prediction for
every person.

07 What older adults and families can do
Treat moderate heat seriously, not only heat-wave warnings with extreme
temperatures. Spend time in air-conditioned spaces when possible, including
public cooling centers, libraries or malls. Cool showers, wet cloths and fans
in moderate conditions can help, though fans alone may be less effective in
very high heat. Drink fluids regularly, and ask a clinician whether any
medicines affect heat tolerance or fluid needs. Stand up slowly, especially in
heat, to reduce dizziness and fall risk. Families and neighbors can check on
older adults during hot periods, especially those living alone. Know the signs
of heat illness, including confusion, fainting, nausea and very hot skin, and
call 911 if they appear.

08 The long view on heat and health
As heat waves become more frequent and longer, more older adults will face
repeated exposure. This trial suggests the body does not simply adapt over a
few days, and warm nights do not provide full recovery. For individuals, the
practical questions are: Where can I cool off? Do my medicines affect heat
tolerance? Who will check on me during a heat wave? For communities, cooling
centers, outreach programs and heat-health warning systems can reduce risk. For
housing and building policy, access to cooling is increasingly a health issue.
The long-view idea is that heat risk for older adults begins earlier than many
warnings suggest. Staying cool is not comfort. For aging bodies, it is
protection.


The Takeaway

1 In a randomized crossover trial, a three-day moderate heat wave raised older
adults' daily peak core temperature by about 0.4°C.
2 The temperature rise recurred each day, and warm nights did not reset it.
3 Heart rate rose, blood pressure dropped more on standing, and kidney and gut
stress markers increased.
4 The study was small and measured physiological strain, not heat illness or
deaths.
5 Older adults benefit from cooling strategies during moderate heat, not only
extreme heat waves.
Stay patient, stay curious,
T.C. Brown
Editor, True Capital Talk


Sources & Further Reading

• Effects of a 3-day simulated heatwave on physiological and functional
outcomes in older adults in Canada —The Lancet Planetary Health, September 30,
2026 <[link removed]>
• Heat and health — Centers for Disease Control and Prevention
<[link removed]>
• Hot weather safety for older adults — National Institute on Aging
<[link removed]>
• Climate change: heat and health — World Health Organization
<[link removed]>
For educational and informational purposes only. Nothing here is a diagnosis
or individualized medical advice. Signs of heat illness such as confusion,
fainting or very high body temperature require emergency care; call 911. Talk
to a clinician about how medicines affect heat tolerance.  


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