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May 5, 1978

Accidental Hypothermia in the Elderly

JAMA. 1978;239(18):1888. doi:10.1001/jama.1978.03280450060030

Like many adjustments to environmental stimuli, the adaptation to temperature changes becomes less efficient with advancing age. When exposed to cold, the aged do not increase their heat production as well as do the young. Nor are they able to control as effectively their heat loss by peripheral vasoconstriction. Often, they are less able to sense the cold than they did when they were younger.

Accidental hypothermia is more common and more lethal in the elderly. It is also less easily recognizable. In children and in adults younger than 60 years of age, the cause of hypothermia is obvious. Usually it is an exposure to extreme cold under special circumstances. The victim may be a mountain climber caught in a snowstorm, a fisherman whose boat capsized in cold waters, or an alcoholic found asleep in the snow.

In the older person, the circumstances are less dramatic and the cause less