Heat waves represent a public health risk to elderly people, and typically result in an increased rate of hospital admissions and deaths. Studies of thermoregulation in this cohort have generally focused on single elements such as sweating capacity. Sweating capacity and skin blood flow reduce with age, reducing ability to dissipate heat. Perception of effort during heat exposure is emerging as an area that needs further investigation as the elderly appear to lack the ability to adequately perceive increased physiological strain during heat exposure. The role of the gut and endotoxemia in heat stress has received attention in young adults, while the elderly population has been neglected. This shortcoming offers another potential avenue for identifying effective integrated health interventions to reduce heat illnesses. Increasing numbers of elderly individuals in populations worldwide are likely to increase the incidence of heat wave-induced deaths if adequate interventions are not developed, evaluated, and implemented. In this narrative-style review we identify and discuss health-related interventions for reducing the impact of heat illnesses in the elderly.

OBJECTIVE:To evaluate the longitudinal effect of a group physical activity service to help patients self-manage un-resolving back pain. BACKGROUND:Back pain is one of the most common and costly conditions. Large scale trials have demonstrated a role for less traditional treatment including exercise, yet the long term effects of patient centred, group physical activity programmes remains unclear. METHODS:One hundred and eighty one un-resolving back pain patients (aged 53 ±17 years) completed a 6x2h physical activity programme. All activities were relevant to activities of daily living and incorporated activities to develop aerobic fitness, flexibility, core activation, and muscular strength & endurance. Dietary advice, home diaries and pedometers were provided. RESULTS: Measures of back pain, aerobic fitness, muscular endurance and body composition showed significant (p < 0.05) pre-post intervention improvements. Disability rating decreased by 19% alongside improvements in aerobic fitness (15%), back extension (36%) back flexion (16%) and grip strength (5%). Six month follow up identified (p < 0.05) reductions in body fat (6.5%) whilst aerobic fitness, disability rating and muscular strength & endurance remained stable. CONCLUSION: Group physical activity programmes could contribute to the self-management of back pain, enabling sustained improvements in fitness, physical activity and body fatness.