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Just when it felt like summer was winding down, the heat is making an unwelcome return, even here in Ohio. Temperatures are climbing well above normal across the region and have been in the last few weeks in parts of the U.S. and Europe, bringing a wave of late-season warmth. Health experts warn this kind of prolonged heat can be especially dangerous for older adults, whose bodies are less able to cope with extreme temperatures. As the hot weather lingers, concerns are growing for aging populations and others at heightened risk of heat-related illness.

“Heat illness is almost 100% preventable,” said Angela Hillman, an expert in exercise physiology and associate professor in OHIO’s College of Health Sciences and Professions. “But it’s also one of the most overlooked and underestimated health threats, especially for those who aren’t prepared for it.”

Excessive heat by itself isn’t always the problem. Hillman explained that the real danger comes when heat is combined with humidity, or with physical exertion in hot environments.

“Humidity makes it more difficult for sweat to evaporate from the skin, and that’s our body’s primary way to cool down,” she said. “When it’s humid, even if you're sweating, you may not be cooling.”

In dry heat, like in desert climates, the body still risks overheating, particularly if someone is not well-hydrated, is physically active, has a low fitness level or exposed to direct sunlight for long periods.

“If the temperature outside is higher than your body temperature, your body will start to absorb heat instead of releasing it,” Hillman added.

This thermal imbalance can lead to a dangerous rise in core body temperature, and the effects don’t stop when activity ends.

“People often think, ‘I stopped moving, I’m in the shade, I’ll cool off now.’ But your body temperature continues to rise for 20 to 30 minutes after exercise stops. That’s why cooling needs to happen immediately in cases of heat stroke, before someone is transported to the hospital,” she said.

Among the groups most affected by extreme heat are older adults.

“As we age, our bodies become less efficient at regulating temperature,” said Hillman. “There’s a decrease in blood flow to the skin, fewer temperature receptors and fewer active sweat glands. That all adds up to impaired cooling.”

In addition to physiological changes, older adults are often on medications that increase their risk in the heat. Diuretics, beta-blockers for blood pressure, antidepressants, anxiety medications, and even over-the-counter products like Benadryl and Sudafed can interfere with the body’s ability to respond to rising temperatures.

“Chronic conditions such as heart failure or Parkinson’s disease further complicate the picture,” Hillman said.

Hillman emphasizes that prevention starts with awareness and preparation.

“Using a fan indoors, especially when there’s no air conditioning, can make a big difference,” she said. “Air movement helps evaporate sweat and also makes people feel cooler, even if their body temperature hasn’t changed yet.”

Maintaining physical fitness is also key, with Hillman noting that regardless of age, people with higher fitness levels sweat more effectively and can thermoregulate better.

She recommends gradual exposure to heat as another important strategy for alleviating heat illness.

“People who are gradually acclimated to the heat, either passively or through physical activity, will handle high temperatures better. That’s why heat illness is so common in early summer, when people aren't used to the heat yet,” Hillman added.

Proper hydration, wearing light and breathable clothing and avoiding activity during the hottest part of the day are also critical strategies.

Among aging adults, heat syncope, or fainting, is one of the most common heat-related conditions.

“It happens when blood is diverted to the skin for cooling and not enough reaches the brain,” said Hillman. “It’s especially risky when people are standing still for long periods or get up too quickly.”

Older adults are also at increased risk for heat exhaustion and heat stroke, the latter of which is life-threatening and defined by a core body temperature over 104°F.

Ultimately, Hillman believes that heat illness is largely a result of inadequate preparation, not just hot weather.

“The real cause is a lack of fitness, hydration, and acclimation,” she said. “People who are sedentary and haven’t been exposed to heat are the most at risk, especially when temperatures suddenly spike.”

It’s not just the middle of summer we need to worry about, either, according to Hillman the early hot days in May, after a long cold winter, can be even more dangerous than the middle of summer because we have not acclimated to the heat yet.

With weather extremes becoming more frequent, including heat waves, Hillman stresses that communities and individuals alike need to take heat illness seriously and take steps to protect those most at risk.

• Stay Cool Indoors - Use air conditioning when possible. If not available, use fans and keep air circulating, especially during the hottest parts of the day.
• Stay Hydrated - Drink plenty of water throughout the day, even if you're not thirsty. Avoid alcohol and caffeine, which can contribute to dehydration.
• Avoid Peak Heat Hours - Limit outdoor activities to early morning or late evening, avoiding being outside during the hottest parts of the day, typically between 10 a.m. and 4 p.m.
• Wear Light, Breathable Clothing - Choose loose-fitting, light-colored clothing made from breathable fabrics like cotton or moisture-wicking materials.
• Know Your Medications - Be aware that some medications (like diuretics, beta-blockers, or antihistamines) can impair your ability to regulate temperature.
• Watch for Warning Signs - Be alert for symptoms like dizziness, headaches, rapid heartbeat, confusion or fainting, all of which may signal heat exhaustion or heat stroke.