The weather has been ridiculous.

It also can be dangerous, especially for old people. And with August upon us, probably the worst is yet to come.

Last summer more than 1,000 people died in the United States from ailments specifically related to heat. Most of them were over 65. Government statistics stated flatly that "heat stroke rates in persons ages 65 and older were 12 to 13 times the rates in the remainder of the population."

And probably even more older people died from illnesses exacerbated by the heat, but not listed as such.

The National Institue of Aging has issued a special advisory on the weather this year, incorporating new information about the impact of certain disorders and drugs on the body's ability to throw off heat -- the natural way -- by sweating.

And The Medical Letter has issued a warning to runners, joggers and other hot-weather exercisers.

The elderly in general are less able to adjust to extremes of heat or cold.

According to Dr. Robert N. Bulter, director of the National Institute of Aging, "one of the realities as we grow older is that our boides alter in their vulnerability to a variety of things like temperature regulation, all as a consequence of the passage of time."

(He also notes that 65 is anarbitrary age. Change can kick in earlier or later.)

But in addition to the inevitable ravages of time, there are other things which effect the way the body reacts to its environment.

A healthy body will respond to heat by opening the blood vessels near the surface of the skin where it is cooler. This increases blood flow and sweating and thereby lowers body temperature.

In a person with heart and circulatory ailments, this process is impaired, so that the person becomes more susceptible to heat stroke, a potentially lethal situation.

Other factors incresing this vulnerability are:

Diuretics, drugs often prescribed for high blood pressure.

So-called anticholinergic drugs, agents sometimes used in the treatment of Parkinson's disease, for example. Also some anti-depressants, and tranquilizers in the phenothiazine class.


Fever from an infection.

Alcohol. (Cool water is better than cool beer.)

Don't stop taking your medicine, but do take particular precautions. Heat stroke is a total system breakdown, a major medical emergency. Symptoms are: faintness, dizziness, nausea, mental confusion, loss of consciousness, rectal temperature of 104 degrees or more, rapid pulse and flushed skin. Keep the victim cool. Seek immediate medical aid.

Heat exhaustion is less serious immediately, but also requires prompt treatment. It stems from a loss of body fluids and salt.

Symptoms: weakness, heavy sweating, nausea and light-headedness.

Treat with cool liquids, sponge baths and bed rest.

Overeager athletes also can increse their vulnerability to what is called "heat injury."

Metabolic heat, notes The Health Letter, "increases with running speed or exertion." The hotter the day, the higher the humidity and the faster the pace, the greater the danger. There also seems to be enhanced danger when runners increase their speed, as in a spurt at the end of a race.

Some recommendatins apply to both athletes and elderly people:

Drink somewhat more water or fresh fruit juices than thirst dictates. (The NIA suggests that older people, not on salt or fluid restricted regimes, drink at least a gallon of liquid a day when the outside temperature is above 95 degrees and no air conditioning is available.)

Avoid sugared drinks, alcoholic beverages or beverages high in salt, as in some club sodas.

Do NOT take salt tablets unless a physician specifically approves.

And for the seniors, especially:

Dress in light, loose clothing.

Keep exercise to a minimum.

Don't economize with your air conditioning -- the risk of illness or death is a poor tradeoff for a lower electric bill.

Take frequent cool baths or showers if you have no air conditioning. (Don't forget to remove things like hearing aids first)

Stay our of the sun.

Get a neighbor or friend or relative to check in on you frequently.

Finally, says the NIA, take the heat seriously. It's not just something to complain about, and, on the other hand, says Dr. Butler, "you don't have to die to suffer from heat exhaustion and heat stroke."

"Temperature regulation," mused Butler, "reflects the general aspect of what growing old is all about. . . . Among other things, it demonstrates that one of the needs of research in aging is to study all the factors which make us vulnerable to other things, how age alters the way in which other things affect us, like cancer, or why pain perception and registration differ. It's just one of the fascinating aspects of the pathophysiology of aging which we're just beginning to get a glimpse of."