Copyright independent
As temperatures have plummeted in recent weeks, ushering in the official start of scarf season, many are feeling the chill more acutely. For those finding themselves increasingly sensitive to the cold, even with multiple layers, advancing age could be a significant factor. Dr Elise Dallas, a GP at London General Practice, has explored six common reasons why individuals tend to feel the cold more acutely with age. She also offers practical advice for staying warm and comfortable as the colder months intensify. A slower metabolism contributes to feeling colder as you age. “Metabolism slows with age due to reduced lean muscle mass and hormonal changes,” explains Dallas. “Thyroid function declines, especially free T3 levels, which lowers metabolic rate and heat production. Adrenal changes include reduced DHEA (Dehydroepiandrosterone) and altered cortisol rhythms, which can affect energy balance and thermoregulation. “Thermogenesis, the process of heat production in the body, becomes less efficient. It includes basal metabolic heat, shivering, and non-shivering mechanisms like brown fat activation.” Many of us tend to lose muscle and fat later on in life, which reduces our body’s insulation. “Muscle mass declines due to sarcopenia, reducing heat generation. Subcutaneous fat also decreases, reducing insulation,” says Dallas. “Fat redistributes from limbs to central areas, which lowers peripheral warmth.” Circulation tends to naturally decline with age. “Blood vessels stiffen and vasodilation becomes less responsive,” says Dallas. “Peripheral circulation slows, especially in extremities, reducing heat delivery. Autonomic regulation of blood flow also weakens, making it harder to maintain warmth.” Chronic conditions such as hypothyroidism, anaemia and diabetes can all increase sensitivity to cold in older adults by affecting the body’s ability to generate and circulate heat. “Hypothyroidism reduces metabolic heat production and anaemia lowers oxygen delivery to tissues, reducing cellular energy and heat,” explains Dallas. “Whereas diabetes can cause peripheral neuropathy and vascular damage, impairing heat sensation and circulation. “In addition, heart failure reduces cardiac output, limiting blood flow to the skin and extremities and Raynaud’s phenomenon causes exaggerated vasoconstriction in response to cold.” Due to age-related changes in the body and the common use of multiple medications, older adults are more susceptible to side effects. “Diuretics – including thiazide (e.g. bendroflumethiazide), a loop (e.g. furosemide), and potassium-sparing (e.g. spironolactone) can cause dehydration and electrolyte imbalance, impairing thermoregulation,” says Dallas. “Antidepressants such as SSRIs (e.g. sertraline, fluoxetine) and tricyclics (e.g. amitriptyline) may affect hypothalamic temperature control and cause vasoconstriction. “Furthermore, vasodilators like calcium channel blockers (e.g. amlodipine) and alpha-blockers (e.g. doxazosin) can impair vascular tone and heat retention and beta-blockers (e.g. bisoprolol) reduce cardiac output and peripheral circulation.” An array of other age-related factors all play a part too. “Thinner skin, reduced sweat gland function, lower physical activity, and impaired hypothalamic response all reduce the body’s ability to sense and respond to cold,” adds Dallas. “Lower calorie intake and reduced brown fat activity also contribute.” “Yes, exposure to cold temperatures lead to any serious health problems for older adults,” says Dallas. “Hypothermia can occur, even indoors, and cold stress increases cardiovascular risk, worsens arthritis, and can impair cognition and mobility, increasing fall risk. Frostbite is also a risk in severe cold.” “Wear thermal layers including hats, gloves and socks,” advises Dallas. “Also, keep indoor temperature at least 20°C, use heated blankets or hot water bottles safely and check for draughts and insulate windows and doors. “In addition, eat regular, warm meals, stay hydrated and try to stay active indoors to boost circulation.”
