Abstract
Background
High indoor temperatures require behavioral adaptation, especially among vulnerable older adults. There are uncertainties as to the degree to which people adapt to these challenging conditions.
Objective
The aim of this study was to describe the degree of adaptation of social participation and other heat-related behavior with respect to higher indoor temperatures.
Methods
In this study 81 residents from 10 sheltered living facilities (84% women, mean age 80.9 years) were visited every 4 weeks from May to October 2015 and additionally during 2 heat waves in July and August 2015. The indoor temperature, drinking and clothing and social participation were documented. Baseline documentation of gait speed and residential area were used to create subgroups of people with high or low gait speed and with facility location in a garden city/suburb or city/city center.
Results
Social participation and clothing decreased with −4.53 in the World Health Organization participation score units (95% confidence interval CI −5.32; −3.74) and −0.41 for clothing units (95% CI −0.46; −0.37) and volume of drinking increased (0.65 l/day; 95% CI 0.52; 0.77) per increase of indoor temperature by 10 °C. The negative association between indoor temperature and social life participation was stronger if functional capacity was low or if the facility was located in the city/city center. Not all older adults displayed temperature-related adaptive behavior.
Conclusion
For older adults the negative association between indoor temperature and social life participation was stronger in the city/city center or if their functional capacity was low. Frequent personal contact and motivation of those who are frail might be helpful to support their adaptive behavior of drinking and clothing during heat stress.
Zusammenfassung
Hintergrund
Hohe Raumtemperaturen erfordern ein angepasstes Verhalten, besonders in der Gruppe vulnerabler Älterer. Das Ausmaß solcher Anpassungen an diese Herausforderungen wurde bisher nicht untersucht.
Fragestellung
Ziel der Studie war es, das Ausmaß der Anpassungen der sozialen Teilhabe und anderer hitzebedingter Verhaltensänderungen bezüglich hoher Raumtemperaturen zu beschreiben.
Methoden
Einundachtzig Bewohner aus 10 Einrichtungen des Betreuten Wohnens (84 % Frauen, Durchschnittsalter: 80,9 Jahre) wurden von Mai bis Oktober 2015 alle 4 Wochen und zusätzlich während 2 Hitzewellen im Juli und August 2015 untersucht. Neben der Raumtemperatur wurden die soziale Teilhabe, die Bekleidung und das Trinkverhalten erfasst. Über die Gehgeschwindigkeit (hoch vs. niedrig) und den Wohnort (Gartenstadt/Vorort vs. Stadt/Stadtzentrum) wurden Untergruppen definiert.
Ergebnisse
Bei einem Anstieg der Raumtemperatur um 10 °C verringerte sich die soziale Teilhabe und die Bekleidung (−4.53 Weltgesundheitsorganisations(WHO)-Teilhabe-Score; 95 % Konfidenzintervall (CI) −5,32 bis −3,74 bzw. −0,41 clothing-units; 95 % CI −0,46 bis −0,37) und die Trinkmenge nahm zu (0,65 l/Tag; 95 % CI 0,52–0,77). Der Zusammenhang zwischen Raumtemperatur und sozialer Teilhabe war bei Bewohnern mit geringer Gehgeschwindigkeit und mit Wohnort in Stadtzentrumsnähe deutlicher. Nicht alle Älteren zeigten bei steigender Raumtemperatur ein angepasstes Verhalten.
Schlussfolgerungen
Bei älteren Menschen mit einer Wohnung in Stadtzentrumsnähe oder mit körperlicher Schwäche ist der negative Zusammenhang zwischen Raumtemperatur und sozialer Teilhabe stärker. Intensive Fürsorge könnte das Trink- und Kleidungsverhalten von gebrechlichen Älteren bei Hitze unterstützen.
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Acknowledgements
This work was supported by the German State Ministry Baden-Württemberg for Environment, Climate and Energy Industries (KLIMOPASS 4500412311/23). The sponsors did not play a role in designing the study, data collection and analysis, decision to publish and preparation of the manuscript. We thank Anja Stotz for the data collection.
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C. Becker has a financial relation to Lilly company and Bosch company. U. Lindemann, D.A. Skelton, Juha Oksa, N. Beyer,K. Rapp, and J. Klenk declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Lindemann, U., Skelton, D.A., Oksa, J. et al. Social participation and heat-related behavior in older adults during heat waves and on other days. Z Gerontol Geriat 51, 543–549 (2018). https://doi.org/10.1007/s00391-017-1338-8
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DOI: https://doi.org/10.1007/s00391-017-1338-8