Causes and Treatment of Hypothermia in Older People

What Is Hypothermia?

Hypothermia is a condition where the body temperature is severely low due to excessive heat loss from the body. When the body temperature drops below 95 degrees Fahrenheit or 35 degrees Celsius, it is hypothermia. It is common during the winter season or in people living in places with cold climates. The normal body temperature of humans is approximately 98.6 degrees Fahrenheit or 37 degree Celsius. However, it can vary slightly higher or lower. But when it lowers significantly, the symptoms of hypothermia begin. Older people are at higher risk than younger people because they have increased sensitivity to the cold, making it unbearable.

What Causes Hypothermia in Older People?

Older people can develop hypothermia even in warm climates. As age advances, the metabolic rate decreases, which in turn leads to less generation of heat. So, the body’s mechanism to generate heat deteriorates. When heat loss dominates heat generation, the body's tolerance to the cold decreases. However, certain diseases and lifestyle factors can increase the severity of hypothermia in older people. Some of them are:

• Diabetes Mellitus: In patients with type 2 diabetes mellitus, hypothermia is a common complication. Due to decreased blood glucose levels, heat dissipation, dilation of peripheral vessels, and sweating occurs.

• Hypothyroidism: Hypothyroidism causes low metabolism and vasoconstriction, which leads to decreased tolerance to the cold.

• Parkinson’s Disease: Accidental hypothermia is often seen in neurodegenerative conditions like Parkinson’s disease. Autonomic dysfunction in Parkinson’s disease can cause excessive sweating and vasoconstriction, causing hypothermia.

• Arthritis: Arthritis is a disease that causes inflammation or swelling and tenderness in joints. It's a major risk factor for hypothermia.

• Dementia: People with dementia often forget to wear protective clothing while going out in cold climates, which can result in frostbite.

• Alcohol and Drug Use: Alcohol and drug use can impair the judgment of cold and may create a false impression of warmness inside. This can make people go outside in cold climates, causing blood vessels to constrict, leading to hypothermia.

• Poor Nutrition: Poor nutrition can increase the risk of hypothermia, especially in older adults.

• Medications: Medications such as antidepressants, antipsychotics, painkillers, and sedatives can reduce the body's tolerance to changes in temperature.

What Are the Symptoms of Hypothermia in Older People?

The most common symptoms of hypothermia in older people include:

• Pale, cold, and dry skin.

• Uncontrollable shivering.

• Excessive tiredness.

• Stiffness in the arms and legs.

• Loss of consciousness.

• Pulse becomes weak.

• Slurred speech.

• Feeling extremely sleepy.

• Confusions.

• Lack of coordination.

• Weak pulse.

• Discomfort or pain.

What Are the Warning Signs of Hypothermia?

Apart from the signs and symptoms, hypothermia can show warning signs that indicate complications in some people. Caretakers, family, or the person themselves should contact emergency services when they notice these warning signs.

• Pale skin.

• Angry or confused.

• Extremely cold hands and feet.

• Drowsiness.

• Shallow breathing.

• Blacking out or unconsciousness.

What Is the Treatment for Hypothermia in Older People?

The treatment of hypothermia aims to warm the body. Before medical help arrives, the caretaker or family members can follow the following first aid measures to warm up the body of a hypothermic person.

• Make the person comfortable by bringing them to a warm environment. Care should be taken while handling the person, and it should be gently done. Do not try to rub or massage feet, hands, or any body part, as excessive movement may cause a heart attack.

• Cut the person's wet clothing and comfort them with a blanket by covering it over their whole body but not the mouth. Sharing body heat is also an effective method.

• Make sure not to expose the person to direct heat as it affects the skin and heart.

• Warm beverages can be offered to the person as they can increase body temperature.

• Applying warm and dry compresses like a warm water bottle or towel can bring relief, and it should be applied only to the neck, chest, and groin.

• Persons' breathing and pulse rate has to be monitored. If the person is unresponsive, CPR (Cardiopulmonary resuscitation) must be done by someone trained.

After the person reaches the hospital, pulse rate, body temperature, oxygen saturation, and blood pressure will be checked. Doctors will treat hypothermia by taking some blood from the patient, warming it from outside, and again infusing it. Warm saline is also injected in most cases.

What Are the Complications of Hypothermia in Older People?

If left untreated, hypothermia can end up in life-threatening complications.

• Frostbite: It is the freezing of skin and underlying tissues. It occurs when a person gets exposed to a temperature below zero degrees Celsius. Frostbite is common during the winter season, at high altitudes, and in windy weather. It can often lead to necrosis (death of the cells which occurs due to infection or injuries). Older people with arthritis, diabetes, hypothyroidism, and smoking habits are at high risk for frostbite.

• Gangrene: It is a condition where a body part gets dead due to obstruction of blood flow or any infection. Gangrene causes permanent and irreversible damage to a specific body part and may end up in its amputation.

• Trench Foot: It occurs when the person gets exposed to extremely cold temperatures for a long time. Trench foot can cause the breakdown of skin and other tissues, which increases the risk of contracting infections.

How Can Older People Prevent Hypothermia?

The following tips can prevent hypothermia and its associated complications in older people:

• Always check the weather forecast and wear protective clothing appropriately.

• Avoid swimming during the cold season and wear water-repellent clothing during rain and snow.

• Inside the home, set the thermostat between 68 and 70 degrees.

• Always wear a hat, glove or mittens, scarf, etc., while going out to prevent heat loss from the body.

• Avoid drinking alcohol and caffeinated drinks to prevent excessive heat loss from the body.

• Eating enough food as fat under the skin can prevent heat loss.

• Seek medical help when the body temperature falls below 95 degrees Fahrenheit.

Conclusion:

Hypothermia is the loss of heat from the body, making the person less tolerant to cold. Many conditions can cause hypothermia. Old age is also a risk factor for hypothermia because of low skin thickness and low metabolism in older people. During old age, the body may not be able to regulate the temperature like in young age. However, by taking extra care and managing other risk factors, older people can prevent hypothermia and its complications.