Physiological and perceptual responses in the elderly to simulated daily living activities in UK summer climatic conditions

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. Study design: Mixed-method, randomised research design. Methods: Twenty-eight participants (17 males, 10 females and 1 transgender female) were randomly assigned into three experimental groups; 15°C, 25°C or 35°C, with 50% relative humidity. Participants completed one preliminary and three experimental trials within their assigned environment. The data from the preliminary incremental recumbent cycling test was used to calculate participant's individual exercise intensities equating to 2, 4 and 6 metabolic equivalents (METs) for the subsequent trials. During experimental trials, participants completed 30-min seated rest and 30-min cycling. Results: No change was observed in thermal comfort ([TC] just uncomfortable in both trials), and only modest changes in ratings of perceived exertion (14 ± 2 vs 15 ± 2) at 6 METs in 25°C compared with those in 35°C were observed. In contrast, thermal strain markers did significantly increase (P < 0.05) across the same conditions, including change in rectal temperature (ΔT_re) during exercise (0.27 ± 0.17°C vs 0.64 ± 0.18°C) and peak skin temperature ([T_skin] 32.94 ± 1.15°C vs 36.11 ± 0.44°C). Conclusion: When completing exercise that equates to activities of daily living, elderly people could have a decreased perceptual awareness of the environment even though physiological markers of thermal strain are elevated. Consequently, the elderly could be less likely to implement behavioural thermoregulation interventions (i.e. seek shade and/or remove excess layers) due to a decreased awareness of an increasingly thermally challenging environment.