Toward a Better Understanding of the Thermal and Cardiovascular Strain Experienced by Older Adults During Extreme Heat Events
Bibliographic record
Abstract
This thesis evaluated physiological responses of young and older adults during extreme heat events and the extent to which commonly recommended heat-health guidelines (indoor temperature limits) and heat mitigation strategies (cooling centres) are effective at limiting hyperthermia and cardiovascular burden. A multidisciplinary narrative review and three experimental studies were conducted. In the review, the mechanisms by which aging impairs the regulation of body temperature and hemodynamic stability, and how they may contribute to the increased risk of heat-related mortality and morbidity in older adults, were summarized. A lack of ecologically minded study designs in previous research evaluating the physiological responses supporting homeostasis and health during heat stress (i.e., body temperature regulation and cardiovascular stability) was also identified. The three experiments were therefore designed as day-long (8-9 hour) extreme heat simulations to 1) evaluate age-related alterations in thermoregulatory and cardiovascular function during peak heat conditions; 2) assess how these responses translate to indoor environments; and 3) quantify the effectiveness of cooling centers, a widely recommended heat mitigation strategy, for limiting hyperthermia and cardiovascular burden. In the first study, healthy older adults (age: 64-78 years; n=19) stored 87 kJ [95% confidence limits: 33, 141] more heat than their younger (age: 19-31 years; n=20) counterparts (328 [71] kJ vs. 241 [SD: 87]; P<0.001) during the first three hours of a 9-hour exposure to extreme heat (40°C and 15% relative humidity). This resulted in a 0.4°C [0.2, 0.6] greater increase in body core temperature in the older adults that was maintained throughout exposure (1.0 [0.3] vs 0.6 [0.3]°C; P<0.001). These findings were extended in the second study, wherein it was demonstrated that healthy older adults (age: 66-78 years, n=8) exhibit progressive elevations in body temperatures (P<0.001) and attenuations in cardiovascular autonomic function (P<0.001) during 8 hours of rest in conditions representative of those experienced indoors during extreme heat events. These ranged from an actively cooled environment (22°C), through indoor temperature thresholds recommended by Toronto Public Health (26°C) and the World Health Organization (31°C), to poorly insulated and ventilated homes and/or dwellings without access to air conditioning (36°C; 45% relative humidity in all conditions). In the third study, it was shown that short-term exposure to a cool environment midway through (hours 5-6) a day-long (9 hour) simulated heat event reduced core temperature in a group of healthy older adults (age: 67-78 years; n=8) by 0.8°C [0.6, 1.0] compared to an age-matched group not removed from the heat (from study 1). Despite this, core temperature rose rapidly upon return to the heat and was statistically equivalent in both groups by the end of exposure (37.8 [0.3] vs 37.9 [0.3]°C; P=0.011). The findings of this thesis indicate that even healthy older adults experience sustained elevations in body temperature and cardiovascular burden during extreme heat events and that commonly recommended heat-health guidelines (indoor temperature limits) and mitigation strategies (cooling centres) may not provide adequate protection. Collectively, this work represents a considerable advance in our understanding of the physiological burden experienced by older adults during hot weather and extreme heat events.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".