Older adults often underestimate their vulnerability to extreme heat and are frequently unprepared for prolonged periods of hot weather. This concern is highlighted in a new review of more than forty studies, which found that while seniors may take basic steps during a heatwave, such as drinking water or moving to a cooler space, far less is known about how they prepare in advance. The researchers suggest this lack of planning may stem from a low perception of risk, leaving many at greater danger than they realise.
Smitha Rao, assistant professor of social work at The Ohio State University and co-author of the study, emphasised the need to change how extreme heat is viewed. “Heat is rarely considered a disaster in the same way as hurricanes or floods, but it should be,” she said. “Because it is not visible, it is often described as the ‘silent killer.’” The study, published on August 20, 2025, in PLOS Climate, systematically reviewed 41 studies from around the world, spanning the years 2010 to 2024. Most of these, 29 in total, examined how older adults cope with the onset of a heatwave. Only one study looked at long-term preparedness.
The researchers argue that this gap is worrying, given that older adults are one of the fastest-growing segments of the global population. By 2050, the number of people aged 65 and above is expected to surpass the number of children under five. At the same time, the world has experienced unprecedented heat in recent years, with record-breaking temperatures in 2023 and 2024. Co-author Holly Dabelko-Schoeny, professor of social work at Ohio State, warned that strategies used in the past to handle hot weather are no longer sufficient. “We tend to rely on experience, but the reality has shifted. Both individuals and service providers must adapt to this new climate,” she said.
Ageing itself complicates matters. As bodies grow older, their ability to regulate heat changes, and health conditions or common medications may increase susceptibility to overheating. Rao stressed that many older adults and their caregivers are unaware of these risks. This helps explain why so many heat-related deaths occur at home, often quietly during the night, with individuals not realising they were in danger until it was too late. The study underscores the importance of recognising these physiological changes and adapting safety strategies accordingly.
While most research has focused on individual behaviours, a smaller number of studies—seven in total—examined service delivery to older adults during extreme heat or other weather emergencies. Strikingly, more emphasis was often placed on protection from cold rather than heat, further evidence that heat has been underestimated as a hazard. Even fewer studies addressed policy-level responses, despite their importance in preventing harm. The authors argue that governments and organisations must do more to ensure seniors are protected before emergencies strike. Examples include home weatherisation programmes, providing affordable access to cooling systems, and designing tailored interventions that reflect the needs of different communities.
Some local responses show promise. In Columbus, Ohio, the Central Ohio Transit Authority has introduced free bus rides during periods of extreme heat, allowing residents of all ages to reach cooling centres without financial barriers. Marisa Sheldon, director of the Age-Friendly Innovation Center at Ohio State, praised such measures as forward-thinking. “It is good to see policy changes that reflect our new climate reality,” she said. Yet the researchers stress that much more needs to be done, especially to scale up similar initiatives elsewhere.
Finally, communication and trust emerged as key themes in both this review and related work published in Environmental Communication. Older adults, especially those from culturally and linguistically diverse backgrounds, often rely on trusted networks for information during extreme weather events. Co-author Fiona Doherty highlighted the value of relationship-building: “Connecting neighbours, identifying trusted information sources, and strengthening ties between individuals and community agencies are essential. Without that trust, even the best expert advice may not change behaviour.” Taken together, the findings underscore that preparing older adults for extreme heat requires more than short-term fixes—it demands systemic change, proactive planning, and recognition that this invisible threat is every bit as dangerous as more dramatic disasters.
More information: Fiona Doherty et al, Extreme heat preparedness and coping among older adults: A rapid review, PLOS Climate. DOI: 10.1371/journal.pclm.0000689
Journal information: PLOS Climate Provided by Ohio State University
