Extreme heat preparedness and coping among older adults: A rapid review

Extreme heat events are increasing in frequency, duration, and intensity owing to climate change. In light of older adults’ heightened risks of heat-related morbidity and mortality, this rapid review examines and updates current knowledge about their preparedness and coping behaviors for extreme heat. We searched six databases focused on aging, social sciences, and the environment for empirical studies published between 2010 and 2024 focused on extreme heat preparedness and coping strategies among older adults. After screening, we retained 41 articles for data extraction and quality assessment. We organized results according to the social-ecological model across individual actions and structural strategies (e.g., service delivery, residential care, and heat-related policy). Studies were primarily conducted in Australia, Canada, the United Kingdom, and the United States, with fewer studies in low-and-middle-income countries. Most studies focused on individual coping methods, including hydration and cooling, environmental adjustments, and relocation. Seven studies examined social service delivery contexts, highlighting the importance of formalized health response plans to enhance service coordination, resource allocation, and information dissemination. The fewest number of studies examined heat-related policies, such as heat wave response plans, heat action plans, heat warning systems, and national heat plans. Findings from the rapid review suggest that community-engaged researchers and practitioners can effectively implement participatory planning with older adults and service providers to enhance risk awareness and improve communication among older adults and their support networks. Older adults, especially those who are socially isolated or resource-constrained, require special considerations in heat preparedness planning. Future research with older adults, particularly in low-and-middle-income countries, should be prioritized. Findings from this study inform practice and policy interventions, centering perspectives of older adults and their caregivers within the context of their living environments.