Everybody looks forward to summer, but when the temperatures hit triple digits, it’s not so fun. Older adults are especially affected by high temps, physically, with issues like heat stroke and heat exhaustion, but also mentally. Some of my patients tell me that when temperatures climb, they tend to stay indoors, foregoing exercise and other activities such as gardening or even meeting up with friends. This type of isolation can cause depression and anxiety.
According to the American Psychiatric Association, extreme heat can make people cranky, causing road rage, aggression, high stress levels and trouble sleeping. People can also have trouble concentrating and be more impulsive, leading to bad decisions. Studies show that rates of suicide and substance abuse rise during periods of high temperatures.
Extreme heat is especially troublesome for people 65 and older. One reason is many older adults take multiple medications, both over the counter and prescription. Depending on the medication, high temps can affect how their bodies react to the medication. According to the American Psychological Association, many medications prescribed to treat mental illness can interfere with the body’s ability to adjust to heat, which may lead to dangerous heat illnesses. Some of these medications may also increase or decrease sweating, the body’s natural cooling mechanism.
People who take any of the medications listed below should talk to their clinician about how to avoid negative reactions when the temperatures soar.
These include:
Antipsychotics including:
- Haloperidol
- Olanzapine
- Quetiapine
- Risperidone
Selective Serotonin Reuptake inhibitors (SSRIs) including:
- Fluoxetine
- Sertraline
Serotonin and Norepinephrine reuptake inhibitors (SNRIs), including:
- Duloxetine
- Venlafaxine
Tricyclic antidepressants (TCAs) including:
- Amitriptyline
- Clomipramine
Other common medications that may impair the body’s ability to cope with heat include cardiovascular medications, including:
- Diuretics
- Beta blockers
- Antihypertensives
- Anti-platelet medications
- Antianginals
Over-the-counter drugs are not off the hook, either. Many, such as aspirin, nonsteroidal anti-inflammatory drugs (NSAIDS) and acetaminophen can increase the risk of heat-related liver injury and kidney damage due to dehydration, so it’s important to drink plenty of water to stay hydrated.
Another reason older adults may be more affected by high temps is a lack of air conditioning. Many retirees live on fixed incomes and either cannot afford an A/C unit or pay the higher electricity bills that result from its use. Many cities offer residents cooling places such as libraries and senior centers, which can also help reduce feelings of isolation, but living in an unairconditioned home can degrade mental and physical health.
Finally, studies show that extreme heat can affect cognition in all age groups, which may be a serious problem for older adults who already cope with impaired cognition. Hospitalizations and death rates for people with dementia rise during heat waves.
Summer is a great time to make an appointment with a primary care clinician to do a medication check and get more information about coping with high temperatures.
