A block of ice may have helped pave Theodore Roosevelt's way to the White House...
In August 1896, New York City baked for 10 days straight. The heat was brutal. And back then, of course, air conditioning didn't even exist.
Electric fans, which had just been invented in the previous decade, were still rare – luxuries for the rich. In poor neighborhoods, thousands of people lived crammed together where five or six people would share one room.
New Yorkers dragged mattresses onto rooftops and piers... but many would roll off in their sleep and die from falling or drowning. By the time the heat broke, nearly 1,500 deaths had been reported.
Roosevelt was New York City's police commissioner. As the death toll climbed, he pushed the city to distribute ice through police stations to poor families. Thanks to that response, he was able to bolster his reputation as an urban reformer – one willing to act when other officials wouldn't. And five years later, Roosevelt became President of the United States.
Fast-forward 130 years, and almost 90% of American homes have air conditioning. But heat waves still manage to catch folks off guard...
According to a 2025 report from the Lancet Countdown on Health and Climate Change, heat contributes to an average of 546,000 deaths worldwide annually, a rise of 63% since the 1990s.
And in the U.S., a 2025 University of Michigan poll revealed that 63% of Americans age 50 and older reported experiencing extreme heat in the previous two years. But only a scant 6% had discussed emergency preparation with a healthcare provider.
So today, with much of the country bracing for the dangerous heat wave later this week, I'll go over why heat becomes more dangerous as we age, how to recognize an emergency, and my seven tips to stay safe...
Heat Hits Older Folks Harder
Our body's natural cooldown method is to send blood toward the skin's surface and produce sweat. But with age, these systems become less efficient. And other factors complicate things...
- Sweat-gland function declines: Less sweat produced means less cooling from the evaporation of sweat.
- Impaired thermoregulation: The internal "thermostat" in your brain, located in the hypothalamus, has trouble regulating your body temperature.
- Cardiovascular and circulation problems: The heart has a tougher time pumping blood closer to the skin's surface to let some of the heat off. Also, blood vessels have trouble dilating, which is needed for this heat dissipation to happen.
- Dehydration risk: The body's cells store less water and your sense of thirst weakens, putting you in danger of dehydration.
- Chronic health conditions or taking medications that exacerbate these aforementioned factors (like blood-pressure-lowering drugs that make you pee more, for instance).
- Cognitive decline: It can lead to a failure to recognize warning signs of heat illness and/or an inability to remedy the problem. A 2025 JAMA Internal Medicine study looked at more than 3 million Medicare claims from 2000 to 2018 and found that each day of extreme heat adds at least 5,360 more hospitalizations in folks with dementia and Alzheimer's disease.
And get this: The longer the heat wave, the faster we age... According to a Science Advances study published last year that observed 3,686 older Americans, all the hot weather makes us age faster on a molecular level, where even exposure to extreme heat from a week to two months tacked on an extra year in biological age.
These are all reasons why older folks and their caregivers need to be able to recognize the signs of a heat-related emergency...
When Overheating Becomes an Emergency
Heat exhaustion happens when your body overheats and loses too much water and salt.
You might feel the following symptoms:
- Dizziness or feeling faint and lightheaded
- Fatigue
- Loss of appetite
- Racing heartbeat
- Headache
- Nausea or vomiting
- Vision problems
- Weakness
In this case, you'll want to move the person to a cooler location, loosen or remove extra clothing, apply cool, wet cloths, and offer frequent sips of cool water.
On the other hand, heatstroke is a medical emergency.
Heatstroke happens when your body temperature is higher than 104 degrees – it can lead to organ damage and failure.
One big, red flag is a change in brain function that shows up as the person being confused, combative, unsteady, or unable to speak clearly. They may even suffer a seizure or lose consciousness. So with heatstroke, call 911 and focus on moving the person to a cooler, shaded location, removing excess clothing, and applying cold, wet cloths, while holding off on giving fluids since they can become a choking hazard.
Fortunately, most heat illnesses are preventable...
My Top Tips for Preventing Heat Illnesses
- Check more than just the temperature. It's more than just the blazing sun and the heat... Humidity also makes it harder for your sweat to evaporate and cool you down. And poor air quality puts a strain on your heart and lungs. So when making plans, check your local heat index, Air Quality Index, and HeatRisk level. The latter is a relatively new color-coded forecast of how dangerous the heat will be to your health. It ranges from green (little to no risk) to magenta (extreme risk). Also, don't assume noon is the hottest time of day either... Temperatures often keep climbing throughout the afternoon.
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Seek well-ventilated and air-conditioned spaces. If you lose power or don't have air conditioning, try to find a cool place like a senior center, mall, library, movie theater, or restaurant. If you're home, stay on the lower floor. Cover the windows to keep the sun out. And you may want to hold off on firing up the oven or clothes dryer a lot, since those appliances generate extra heat. If you don't have air conditioning, try putting a pan of ice water in front of a box fan to create a cool stream of air.
For elderly loved ones, air conditioning is key – as opposed to fans... A small JAMA Network study published in 2024 involved 18 older adults exposed to high heat (about 97 degrees Fahrenheit) and humidity indoors. Researchers found that using an electric fan did nothing to reduce core body temperature, nor did it lower heart rate.
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Drink plenty of fluids. The first sign of dehydration is thirst. But the problem is, as we get older, we also lose the ability to feel thirsty. Be sure to keep water visible and within reach as you sip steadily throughout the day.
If you're caring for a loved one with dementia or limited mobility, don't just remind them – check later to make sure that they drank the water. (If you have heart failure, kidney disease, or have fluid restrictions, ask your healthcare provider about how to handle extreme heat.)
Working outdoors? The U.S. Department of Labor advises outdoor workers to drink four cups of water every hour when the heat index is between 103 and 115 degrees.
- Add some water... to your skin. While drinking it replaces fluid loss, applying water to the skin helps remove some of the heat. So take a cool shower, run water over your limbs, use cool, damp cloths, or mist exposed skin. A small 2024 study involving older adults aged 67 to 84 found that spraying skin with water reduced the rise in core temperature and eased strain on the heart during extreme heat.
- Break your routine. Whether it's mowing the lawn... gardening... or taking Fido for a long walk, the outdoors can wait. You don't want to mess with extreme heat. So move your exercise or physical activity indoors, shorten it, or skip it altogether. If I have to venture outside, I choose the coolest hours, wear loose, light-colored clothes, and keep my water bottle and phone (in case of an emergency) on me.
- Plan ahead for medications and power outages. Check with your doctor or pharmacist whether any medications you're taking could affect sweat, blood pressure, kidney function, thirst, or hydration. Know which medicines need refrigeration in the event of a power outage. And be sure to charge any backup batteries for electrical devices like breathing machines, oxygen, or wheelchairs.
- Set up a way for family members to check on each other. Keep a list of contacts in case of a power outage. Even if the power stays on, checking in will help make sure you and your other family members are all safe from the heat.
Use these seven tips to help you stay safe this week and for the rest of the summer.
Extreme heat is just one factor that can make a state look more or less appealing when it comes to retirement planning. Other factors matter too, like taxes, healthcare costs, and housing costs, for example. Well, I recently released a guide to choosing the best states for your retirement. You can get your own copy and see which states came out on top here.
What We're Reading...
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Here's to our health, wealth, and a great retirement,
Dr. David Eifrig and the Health & Wealth Bulletin Research Team
June 30, 2026