Florida’s heat wave adds dangerous threat to people with Alzheimer’s
Florida is scorching under the summer sun this year, breaking heat records left and right. This week most of the state has been under extreme heat warnings and watches as temperatures stayed in the 90s and the humidity drove the "feels like" heat index up past 115. It's dangerous for anyone to be out in the sun without taking precautions.
It's even more dangerous if someone may not notice that they're overheating, may not understand what it means, may have impaired judgment, or may not be able to tell anyone about it.
"Summer can be extremely dangerous for those with Alzheimer's in Florida," Julie Shatzer, Vice President of Programs for the Florida chapters of the Alzheimer's Association, said in an email. "Symptoms of overheating can be difficult to detect in those with Alzheimer's and other dementia since they can be similar."
There is also the greater chances for confusion due to "power outages from storms, detours due to flooded roads and general disruptions to daily life" that can lead to an increase in wandering, Shatzer said.
"With the extreme heat, wandering for even a few minutes can be deadly," she said.
In the last decades, extreme heat has killed on average more than 700 people every year in the United States, according to the Centers for Disease Control (CDC), but those numbers are increasing as average temperatures rise. 3,066 heat-related deaths were reported in the U.S. during 2018-2020.
According to a 2013 study by the National Institutes of Health (NIH), people living with Alzheimer's are 6% more likely to die "on an extremely hot day."
On hot days, extra precautions are necessary. Here's what caregivers and families need to know to protect their loved ones.
What is Alzheimer's Disease?
The Alzheimer's Association reports that 13.6% of everyone age 45 and over has some level of cognitive decline. Mild forgetfulness is a normal part of aging.
Dementia is not a normal part of aging. People with dementia struggle to maintain their quality of life or complete normal activities when thinking, learning, remembering and reasoning become difficult or impossible. The most common form of dementia for people over 65 is Alzheimer's Disease, a progressive neurodegenerative disease that worsens over time. A person with Alzheimer's is expected to live 4 to 8 years after diagnosis but can live as long as 20 more years, depending on other factors. People under 65 can and do get Alzheimer's, but it's not as common.
Alzheimer's accounts for 60-80% of dementia cases, according to the Alzheimer's Association. There is no cure, but there are treatments to slow the symptoms.
What are the dangers of extreme heat?
Extreme heat can overload your body's ability to cool itself, which can cause heat stroke, a dangerous and potentially fatal condition. When heat stroke occurs, the body temperature can rise to 106 degrees or higher within 10 to 15 minutes, according to the CDC.
Heat stroke can cause permanent disability or death if the person does not receive emergency treatment.
Why are people with Alzheimer's more susceptible to extreme heat?
People with dementia are at an increased risk for wandering and may be confused by or unaware of extreme heat conditions, with deadly results. They also can be at risk if they cannot tell anyone they are too hot, and the symptoms are harder to detect.
"Heat stroke can be difficult to detect in individuals with Alzheimer's or other dementia since many of these signs are also symptoms as dementia progresses," Shatzer said. Common heat-related symptoms such as increased fatigue, dry mouth and headaches may be difficult to spot.
People living with Alzheimer's may not be aware they are overheating, or know what to do if they are. They may not tell anyone else. They may dress inappropriately for the weather, increasing their chances of overheating. A person who wanders away from a caregiver when the sun is blazing down is in danger from heat stroke or heat exhaustion and minutes can count.
"If an individual is not found within 15 minutes, call 911," Shatzer said.
Some medications can increase the risks for overheating and dehydration by masking telltale symptoms. "People taking diuretics, sedatives or certain heart medications may not sweat as much as others," Shatzer said, "but that doesn't mean they are not hot. The lack of sweating can cause overheating without obvious signs."
What symptoms of extreme heat should caregivers for people living with Alzheimer's watch for?
Sudden, increased confusion
Complaints of a headache
Nausea
Dizziness
Hot, red, dry or damp skin
"If you are seeing symptoms or think there is an issue," Shatzer said, "please contact your doctor immediately."
High temperatures aren't the only problems to watch for, as humidity and air pollution can cause breathing difficulties.
What should caregivers do to keep people living with Alzheimer's safe from extreme heat?
The most important thing is to pay attention, especially if the person has language issues and/or a history of wandering. The Alzheimer’s Association has important safety tips for caregivers and families dealing with dementia during the hot summer days:
Check in regularly with any person living with dementia. "it's critical that caregivers check on their loved one regularly and monitor their condition, Shatzer said.
Be aware. Keep an eye on weather conditions and have a plan ready for extreme heat situations.
Keep them cool. Make sure the person stays indoors in an air-conditioned or cooler space. Leave the a/c on at night, as low temperatures in the Florida summer still stay over 75 degrees, which can heighten anxiety and increase agitation due to difficult sleeping conditions.
Watch for behavioral changes. Heat can increase agitation and confusion in people, even without dementia. Address the person's physical needs related to the heat to remove behavioral triggers, then attend to their emotional needs.
Keep them in cool clothing. People with dementia may not dress appropriately for the heat. "Instead of demanding they change which can lead to arguments and tension for the individual," Shatzer said, "put a t-shirt or appropriate clothing in view. If they get hot then they will change clothes." If you must go outside, wear a hat and apply sunscreen with an SPF of 30 or higher.
Keep them hydrated. Don't force someone to drink fluids but keep water in their reach at all times. Increased water intake is essential to maintaining good hydration and health during extreme heat.
Have a long-distance plan. If you can't be nearby, arrange for someone to check on the person for you. Make sure they have emergency contacts and know where to find important medical info.
Stay cool: As temperatures hit 'dangerously hot conditions' in Florida, here is everything to know to stay safe
If you need assistance, call the Alzheimer's Association 24/7 Helpline at 800-272-3900.
What do I do if someone with Alzheimer's is overheating?
Remove them from the hot environment into a cooler place and remove any outer layers of clothing. Offer small sips of cool water. Wet the skin and clothes or apply cool compresses to help bring temperatures down. Contact the person's doctor to review the symptoms and decide what to do next.
If the person faints, displays excessive confusion, or becomes unconscious, call 911 immediately.
How many people live with Alzheimer's in Florida?
There are more than 580,000 Floridians aged 65 and older living with Alzheimer's, according to the Alzheimer's Association. There are more than 6.5 million Americans living with Alzheimer’s nationwide.
Florida has one of the highest prevalences of Alzheimer's in the U.S. In a county-by-county breakdown in a study by the Rush Alzheimer’s Disease Core Center, six Florida counties were in the top 100 nationwide when looking at counties that have 10,000 or more residents 65 and older:
Miami-Dade County (No. 1, at 16.6% of residents age 65+)
Broward County (No. 34 at 13.9% of residents age 65+)
Palm Beach County (No. 38 at 13.8% of residents age 65+)
Orange County (No. 86 at 21.7% of residents age 65+)
Highlands County (No. 89 at 12.7% of residents age 65+)
Osceola County (No. 95 at 12.6% of residents age 65+).
In 2021 the state reported 553 non-fatal emergency room visits from heat-related injuries for people over 65.
This article originally appeared on The Daytona Beach News-Journal: Alzheimer's in Florida: Heat wave poses extra risks for dementia
