June is Seniors’ Month, a good time to reflect on health issues particularly concerning to older adults – including the risks associated with soaring temperatures – like those being felt across Canada this week – and other climate-related events.

At the latest Sunnybrook Speaker Series, experts shared their insights about how climate change is impacting our health. Dr. Rajin Mehta, a geriatrician and internal medicine specialist and former head of Sunnybrook’s Division of Geriatric Medicine, shared his insights on how climate change, including extreme heat, can impact seniors’ health and well-being.

Temperature and its impact on the body

Temperature affects how humans feel and how bodies function.

“Humans can handle colder temperatures better than heat,” said Dr. Mehta. “The slightest change of just a few degrees in temperature elevation can impact the cells in our bodies, and in turn affect our organs.”

Neurological, liver, cardiac, and renal systems can all be affected by increased temperature, Dr. Mehta said. For older adults, who often have a number of illnesses or health conditions at once (known as multi-morbidity), this can be particularly concerning.

“Higher temperatures affect the function of these very important organs and if someone has more than one impairment in these systems, it can become very complicated, very fast,” said Dr. Mehta.

As people age, it also becomes more difficult for their bodies to regulate temperature, a process known as thermoregulation. Seniors have a decreased ability to thermoregulate, which makes it harder for them to adjust to hotter temperatures, even if the elevation in heat is minimal. This can lead to things like dehydration or heat stroke.

Unfortunately, not all seniors have access to things like air conditioning that can help minimize the effects of extreme heat.

“A person’s socioeconomic status is a critical aspect to consider because it has a direct correlation to one’s health and well-being.”, said Dr. Mehta.

Seniors can also be at increased risk of heat-related illnesses if they are taking certain types of medication, such as anticholinergic drugs which are commonly used to treat bladder and gastrointestinal conditions. These medications can impair the body’s ability to sweat, which is a natural way to cool down when temperatures rise.

Indirect Impacts to Health: Food Insecurity & Displacement

 A concern that’s top of mind for many, especially seniors who may already have limited finances, is food insecurity.

“We cannot forget that global issues impact us locally as well,” said Dr. Mehta.

“Seniors are disproportionately affected by poverty, and many are faced with the decision of paying for food or other costs of living like rent.”

Older people are also at a greater risk of displacement due to climate change, Dr. Mehta said. In the event of an environmental emergency such as a tornado or a flood, older people with limited mobility are more likely to face barriers getting to safety.

Given the increase in climate-change related natural disasters, it is important for seniors to have a safety plan in place in the event of an emergency, Dr. Mehta said, especially if there are underlying health concerns or mobility issues.

Key Takeaways

It is crucial to remember that climate change impacts all of us, but the senior population faces heightened risks.

However, there are steps older adults can take to protect their health, such as remembering to stay hydrated and cool, and talking to a health-care provider about how things like extreme heat events may impact their health or interact with their medications.

For seniors experiencing food insecurity, community resources like food banks can provide help. Some organizations also offer support for delivering food bank services to people who have limited mobility and are unable to leave their homes.

Seniors with limited mobility can also make a plan for family or friends to check in on them or help them find alternative living arrangements in the case of an extreme weather event or hazard.

Climate change impacts everyone, but seniors are especially at risk. Offering support, planning preventative measures, and talking openly about the issue can help lessen the risks and impacts caused by climate change among the senior population.

The post The Impact of Climate Change on the Senior Population appeared first on Your Health Matters.

But Sunnybrook’s Dr. Susan Deering wanted to learn more. The family physician, who specializes in elder care, set out to better understand the health impacts of climate change on older patients and what can be done to mitigate the risks.

“Since I work with seniors this was a really interesting place for me to dig in and explore the ideas being exchanged in this space,” says Dr. Deering, physician lead for Sunnybrook’s division of long term care.

Dr. Deering writes about some of those ideas in a recent article for the journal Canadian Family Physician. Given an aging population and global warming, she writes that doctors and health systems should “work together toward solutions that will help the most vulnerable among us adapt to climate change.”

How does climate change impact the elderly differently?

Our bodies go through many changes as we age, including the ability to sense and respond to shifts in temperature – what is known as thermoregulation.

“We all know seniors who always wear a sweater, even when it’s hot outside, because they constantly feel cold,” Dr. Deering says.

A decreased ability to thermoregulate makes it harder for seniors to adjust to even slightly warmer temperatures, let alone heat waves. Other changes that occur as part of the natural aging process add to the challenge.

“We don’t sweat as much as we get older and the blood flow to the skin decreases, so those cooling mechanisms that our bodies use when it’s hot are not there,” Dr. Deering explains.

In addition, older individuals are often on medication for conditions such as high blood pressure, congestive heart failure or dementia. Warmer temperatures can impact the potency or negative side effects of such medications unless the patient is increasing their fluid intake to compensate – something that seniors often find difficult to do.

Not drinking enough during warm temperatures can also lead to dehydration more quickly with older adults, Dr. Deering adds.

“They can compensate for a while but there’s a point beyond which things turn sour quickly, whether with confusion or disorientation or loss of consciousness.”

When it comes to dealing with poor air quality, older people’s lungs are at a disadvantage too.

“The cumulative effects of sickness like pneumonia or exposure to air pollution throughout our lives make our lungs less resilient as we age,” says Dr. Deering.

Lessons learned from experience

On top of being a clinician, Dr. Deering is an assistant professor at the University of Toronto’s Temerty Faculty of Medicine and is completing her Master of Public Health at U of T’s Dalla Lana School of Public Health.

She points to a growing body of evidence on the health impacts of climate change on older individuals – including Canada’s experience with the ‘heat dome’ in British Columbia in the summer of 2021. Analysis by the B.C. Coroner’s Service found that most of the 619 people who died following the extreme heat event were older adults with chronic diseases who lived alone. Dr. Deering describes those findings as “startling”.

Even without a heat wave outside, older adults can experience negative health effects when indoor temperatures rise. Research from the Netherlands and Germany found the elderly experienced symptoms like thirst, sleep disruption and slower physical function when indoor temperatures increased.

What can be done to help?

Ensuring older people have access to air conditioning and other ways to stay cool when it’s hot, and that they drink plenty of fluids, are crucial to avoiding heat-related illness.

Dr. Deering hopes to see other preventive measures adopted as well. She suggests primary healthcare providers take the time to educate their senior patients about the health impacts of heat before it becomes an issue in order to build up their resilience.

“Just beginning the conversation early with patients is a great place to start,” Dr. Deering says.

“When you have seniors come into your office in March or April, ask them if they have a plan to stay cool in case there is a summer heat wave, ask if they have social contacts who can check on them, and review their medications to see which ones might increase their risk of harm when it’s really hot.”

Public health campaigns and community programs to assist the elderly during extreme heat could also play an important role, Dr. Deering says. For people who are caring for at-risk seniors or responsible for checking in on them during hot temperatures, she says online tools like the one created by the National Collaborating Centre for Environmental Health are a useful guide for how to recognize and respond to heat-related illness.

Still, Dr. Deering believes primary care physicians are uniquely positioned to help seniors stay healthy amid climate change.

“People might ignore or miss a public health announcement, but they tend to trust and listen to their family doctor,” she says.

Whether it’s smoggy skies from raging wildfires or extreme heat events, Dr. Deering says acknowledging that climate change is also a health issue is essential.

“If we are going to get people moving on doing something about climate change, we have to recognize that the impact on our health is significant.”

The post Extreme weather impacts our health – especially as we age. But Sunnybrook’s Dr. Susan Deering has a prescription for how to adapt appeared first on Your Health Matters.

Climate change and health

According to infectious diseases physician and Sunnybrook Research Institute scientist Dr. Samira Mubareka, our changing environment has helped arboviruses (viruses transmitted through insects, such as West Nile) and their vectors (such as mosquitoes) to thrive.

“With climate change, we’re seeing a change in mosquito behaviour and even in mosquito populations themselves,” she says. “It’s opened up the possibility of new viruses and existing viruses to change their epidemiology.”

Longer, wetter and hotter summers have meant arboviruses and their carriers are able to multiply faster and live longer, she says. And with shorter, milder winters, mosquito vectors are overwintering more. She adds that vectors have more opportunities to feed and transmit viruses to other hosts, including humans, plus, with higher temperatures, vectors that used to only live near the equator are expanding their range and creeping north.

“We’re seeing more exotic mosquitoes that normally would not have been able to survive Canadian winters,” says the infectious diseases physician. “Some have been introduced into Southern Ontario.”

And it’s not just viruses that are on the rise, she says. Other pathogens, like the bacterium Borrelia, which can cause Lyme disease, have seen an increase in prevalence too.

“I’ve seen so much Lyme in the past year relative to the 10 years before,” she says.

Reflecting beyond infectious diseases, Dr. Mubareka points out that climate change has done more damage to our health than just increase the spread of pathogens.

In recent years, we’ve also seen negative impacts on cardiovascular health (the federal government estimates 15,300 premature deaths per year in Canada due to air pollution) and sudden death due to heat (British Columbia saw the deadliest weather event in Canadian history last summer, with 595 people killed by heat), to name a couple things.

“We are only scratching the surface. We really need to understand more,” says Dr. Mubareka.

The rise of climate change anxiety

As more work is done to unpack and address this growing problem, and as climate change becomes more visible and harder to ignore, more and more, climate change anxiety is becoming a topic of conversation.

A few years ago, Dr. Anthony Levitt, chief of the Hurvitz Brain Sciences Program at Sunnybrook, spoke briefly with the Globe and Mail about climate change anxiety.

“It got such traction,” he says of the interview. “I got emails and letters from all over the world asking about the subject.”

To better respond to those questions, Dr. Levitt conducted a survey in the United States and Canada to understand climate change anxiety and who it impacts most.

In general, he found that individuals who live in close proximity to events triggered by climate change, such as British Columbians who saw massive floods and numerous fires last year, were more likely to experience anxiety, and sometimes, even depression. Canadians, females and young people between 18 and 29 are also more vulnerable to climate change anxiety.

“They’re experiencing it, they’re seeing it, they’ve been educated in school about it,” says Dr. Levitt, explaining why young adults are feeling the pressures most. “And now, they’re getting into child rearing age; they’re seeing their children, and they’re thinking about what kind of a legacy they’re going to leave them.”

Like other forms of anxiety, Dr. Levitt says if climate change anxiety is affecting someone’s daily functioning, then they should seek help from a professional. However, he says we shouldn’t try to get rid of it altogether.

“There’s a functional part to anxiety. If you’re anxious about climate change, you’re going to mobilize your resources and do something about it. So, we don’t want to completely remove anxiety because that might remove some of the motivation,” he says. “However, we have to be careful. If you become too anxious, it becomes a barrier to effective problem solving, and you end up being paralyzed.”

What you can do

Dr. Levitt says the “antidote,” to both addressing climate change and to mitigating anxiety, is to take everyday action. Feeling that you are contributing to a solution has the dual job of helping the environment and of helping your symptoms of anxiety.

Dr. Mubareka practices this in her own life.

From biking more often to work, to eating less meat, to studying and educating about the complexities of climate change, she says, “I personally find doing something relieves my anxiety.”

And while she wants people to know how serious and multifaceted climate change is, rather than being alarmist, she says she always wants to emphasize what can be done.

“We have an opportunity right now to prevent the spread of emerging infections through mitigating climate change,” she says. “Climate change is very multilateral, very multisectoral, but that means even the small steps matter. We can all do our part.”

The post The far-reaching effects of climate change on health and anxiety appeared first on Your Health Matters.