thermoregulation in the elderly

The skin is the outermost layer of the body with an extensive surface area of approximately 1·8 m2 , and is the first line of defence against a multitude of external pathogens and environmental insults. The skin also has important homeostatic functions such as reducing water loss and contributing to thermoregulation of the body. The structure of the skin and its cellular composition work in harmony to prevent infections and to deal with physical and chemical challenges from the outside world. In this review, we discuss how the structural cells such as keratinocytes, fibroblasts and adipocytes contribute to barrier immunity...

As global temperatures continue to rise, improving thermal tolerance in the aged population is crucial to counteract age-associated impairments in thermoregulatory function. Impairments in reflex cutaneous vasodilation and sweating response can augment the vulnerability of older adults to heat-related injuries following exposure to heat stress. Mechanisms underlying a compromised cutaneous vasodilation are suggested to include reduced sympathetic neural drive, diminished cholinergic co-transmitter contribution, and altered second messenger signaling events...

Amyotrophic lateral sclerosis (ALS) is the major adult-onset motor neuron disease, and is clinically, pathologically, and genetically associated with frontotemporal dementia, the second cause of dementia in the elderly. Here, we review the evidence linking thermoregulation and ALS. Indeed, while ALS is not classically associated with defective thermoregulatory function, its progression severely affects key brain regions controlling body temperature and impacts multiple sensors and effectors of this homeostatic function...

OBJECTIVES: The elderly population is at an increasingly significant health risk to heat-related illnesses and mortality when compared with younger people in the same conditions. This is due to an increased frequency and severity of heatwaves, attributed to climate change, and reduced ability of elderly individuals to dissipate excess heat. Consequently, most excess deaths and emergency visits during heatwaves occur in people aged more than 65 years. The aim of this investigation was to assess the physiological and perceptual responses of elderly people during exercise sessions equating to activities of daily living in UK summer climatic conditions...

Context: There are discrepancies in the seasonality of insulin resistance (IR) across the literature, probably due to age-related differences in the seasonality of lifestyle factors and thermoregulation mechanisms. Objective: To estimate the seasonality of IR according to the homeostatic model assessment-IR (HOMA-IR), glucose, and insulin levels and to examine the role of lifestyle markers [body mass index (BMI) and physical activity] and meteorological factors, according to age...

Older people are always more vulnerable to thermal-related discomfort and health issues because of their diminishing ability to adapt to varying environmental conditions. There exist a few thermoregulation models but most of them did not consider age and ethnic differences. In this study, a standard thermoregulation model for Chinese elders was developed on the basis of literature review and the already established model for the Chinese young people. Furthermore, the standard model was individualized with four parameters (height, weight, sex and age) for more accurate prediction...

PURPOSE: Aerobic training-induced plasma volume (PV) expansion improves thermoregulation, and carbohydrate (CHO) + whey protein supplementation enhanced the effects in older people; however, these were suggested by studies on gym-based cycling training but not on home-based interval walking training (IWT). Moreover, long-term walking training effects on PV remain unknown. METHODS: Seventeen male and 10 female subjects (~69 yr), having performed IWT for ≥24 months before the study, were used...

Creatine is one of the most popular nutritional ergogenic aids for athletes. Studies have consistently shown that creatine supplementation increases intramuscular creatine concentrations which may help explain the observed improvements in high intensity exercise performance leading to greater training adaptations. In addition to athletic and exercise improvement, research has shown that creatine supplementation may enhance post-exercise recovery, injury prevention, thermoregulation, rehabilitation, and concussion and/or spinal cord neuroprotection...

Several mathematical models of human thermoregulation have been developed, contributing to a deep understanding of thermal responses in different thermal conditions and applications. In these models, the human body is represented by two interacting systems of thermoregulation: the controlling active system and the controlled passive system. This paper reviews the recent research of human thermoregulation models. The accuracy and scope of the thermal models are improved, for the consideration of individual differences, integration to clothing models, exposure to cold and hot conditions, and the changes of physiological responses for the elders...

Erythema ab igne (EAI) was a very common disease in the past, when it occurred mainly among people who worked with fire, or in people who had used heat sources in contact with the skin for warming purposes for long time. In the last decades, with the introduction of central heating in the buildings, EAI incidence was remarkably decreased in Western Countries, and it was found almost exclusively among elderly, and in people affected by defects in thermoregulation or alteration of periphery circulation. Recently, a new slight increase of EAI prevalence has been observed, although with some new features...

As people live beyond 100 years, there is an extended period of impaired quality of life for the increasing numbers of individuals with skin disorders. There is also a growing work force of fit elderly individuals who are able to provide low technology skin care and who can teach self-help if well instructed. The International Society of Dermatology's sub-committee Skin Care for All: Community Dermatology seeks to bring together those who care for skin diseases and those who manage wounds, burns, lymphoedema and neglected tropical diseases affecting the skin for the purpose of skin care...

WHAT IS KNOWN AND OBJECTIVE: Hot days are increasingly common and are often associated with increased morbidity and mortality, especially in the elderly. Most heat-related illness and heat-related deaths are preventable. COMMENT: Medicines may accentuate the risk of dehydration and heat-related illness, especially in elderly people taking multiple medicines, through the following mechanisms: diuresis and electrolyte imbalance, sedation and cognitive impairment, changed thermoregulation, reduced thirst recognition, reduced sweat production, and hypotension and reduced cardiac output...

Death due to accidental primary hypothermia in cold climates is relatively common, with previous case series reflecting this. In contrast, hypothermia-related death as a result of an underlying medical cause, such as a brain tumor, is rare. The literature clearly illustrates a theoretical causal relationship between brain neoplasms and hypothermia through the infiltration of the hypothalamus; however, the number of reported cases is minimal. Two cases are presented where autopsy confirmed hypothermia as the cause of death with both cases revealing widespread glioblastoma multiforme in the brain...

Age-related deficiencies in thermoregulation diminish the capacity to defend against heat loss under conditions often encountered during activities of daily living (ADL). A potential consequence of these deficiencies is that elderly individuals could have colder lower limbs, which would exacerbate the age-related decline in plantarflexor contractile properties and compromise recovery from a tripping incident. Moreover, a common self-perception among the elderly is that their limbs are cold. However, this impression has never been documented, especially under ADL conditions...

Aging is associated with changes in thermosensitivity and decreases in the functionality of the autonomic thermoregulation. The underlying mechanisms are, however, not fully understood. Elderly subjects may undergo functional changes in the integration process of the thermal sensory system, especially in their thermal adaptation capacities. To verify this hypothesis, we compared thermal evoked responses in younger and older subjects exposed to thermoneutral (27 °C) and warm (30 °C) environments. In the warm environment, the amplitudes of thermal evoked potentials (EPs) were significantly lower in older than in younger subjects, whereas in the thermoneutral environment, the EP amplitudes were similar in both groups...

A bioheat model for the elderly was developed focusing on blood flow circulatory changes that influence their thermal response in warm and cold environments to predict skin and core temperatures for different segments of the body especially the fingers. The young adult model of Karaki et al. (Int J Therm Sci 67:41-51, 2013) was modified by incorporation of the physiological thermoregulatory and vasomotor changes based on literature observations of physiological changes in the elderly compared to young adults such as lower metabolism and vasoconstriction diminished ability, skin blood flow and its minimum and maximum values, the sweating values, skin fat thickness, as well as the change in threshold parameter related to core or skin temperatures which triggers thermoregulatory action for sweating, maximum dilatation, and maximum constriction...

Osteoporosis is a serious skeletal disease causing an increase in morbidity and mortality through its association with age-related fractures. Although most effort in fracture prevention has been directed at retarding the rate of age-related bone loss and reducing the frequency and severity of trauma among elderly people, evidence is growing that peak bone mass is an important contributor to bone strength during later life. Indeed, there has been a large emphasis on the prevention of osteoporosis through the optimization of peak bone mass during childhood and adolescence...

Assessment of body temperature is important for decisions in nursing care, medical diagnosis, treatment and the need of laboratory tests. The definition of normal body temperature as 37°C was established in the middle of the 19th century. Since then the technical design and the accuracy of thermometers has been much improved. Knowledge of physical influence on the individual body temperature, such as thermoregulation and hormones, are still not taken into consideration in body temperature assessment. It is time for a change; the unadjusted mode should be used, without adjusting to another site and the same site of measurement should be used as far as possible...

PURPOSE: This article investigates the safety of radiofrequency induced local thermal hotspots within a 1.5T body coil by assessing the transient local peak temperatures as a function of exposure level and local thermoregulation in four anatomical human models in different Z-positions. METHODS: To quantize the effective thermal stress of the tissues, the thermal dose model cumulative equivalent minutes at 43°C was employed, allowing the prediction of thermal tissue damage risk and the identification of potentially hazardous MR scan-scenarios...

Infrared thermography (IRT) was compared with the traditional 4-scale feather scoring (FS, with 1 representing the worst feather coverage and 4 the best) method for assessing feather coverage of laying hens. The feather coverage of 6 body parts (head, dorsal neck, front neck and crop, back, breast, and belly), body surface temperature distribution, and relative change in sensible heat loss of 60 laying hens (Lohmann SL white breed) at 28, 56, or 73 wk of age (20 hens per age group) were compared by using IRT...