Int J Sports Med 2002; 23(2): 86-92
DOI: 10.1055/s-2002-20137
Physiology and Biochemistry
© Georg Thieme Verlag Stuttgart · New York

Effect of Cold Exposure on Older Humans

J.  Smolander1
  • 1ORTON Orthopaedic Hospital, Invalid Foundation, Helsinki, Finland
Further Information

Publication History

June 25, 2001

Publication Date:
13 February 2002 (online)


Epidemiological studies have shown excess winter mortality particularly in older age groups. A question is how much these statistics are affected by age-related physiological changes in cold thermoregulation and how much due to other factors related to aging. In experimental studies concerning age and cold stress both whole-body and local exposures have been used mostly in resting subjects with minimal clothing. Older persons, particularly men over ca. 60 years, are less able to maintain core temperature during a given cold challenge compared to younger individuals. Older persons have a reduced cutaneous thermal sensitivity, and a reduced subjective thermal perception during cooling. Thus, older people may require a more intense stimulus to perform protective actions against cold stress. Older persons’ skin vasoconstrictive response to cold is diminished compared to younger persons, which seems partly related to a reduced skin vasomotor sensitivity to sympathoneuronal stimuli. The cold-induced rise in metabolic rate is attenuated in older persons, but the mechanism is unknown. Both central and peripheral components seem to be involved in the age-related changes in regulatory effector functions. Enhanced aerobic fitness may not give added protection against core cooling during cold stress in the elderly, but seems to attenuate older subjects’ heightened blood pressure response to cold. Bronchial responsiveness to face cooling may increase with age. Further studies are needed to examine the age-related changes in non-thermoregulatory responses to cold (e. g. hemodynamics, cardiac function, respiration, autonomic nervous function), and the modifying effects of acute exercise and physical training.


  • 1 Anderson G S, Meneilly G S, Mekjavic I B. Passive temperature lability in the elderly.  Eur J Appl Physiol. 1996;  73 278-286
  • 2 Bernstein L M, Johnston L C, Ryan R, Inoye T, Hick F K. Body composition as related to heat regulation in women.  J Appl Physiol. 1956;  9 241-256
  • 3 Budd G M, Brotherhood J R, Hendrie A L, Jeffery S E. Effects of fitness, fatness, and age on men’s responses to whole body cooling in air.  J Appl Physiol. 1991;  71 2387-2393
  • 4 Collins K J, Dore C, Exton-Smith A N, Fox R H, MacDonald I C, Woodward M. Accidental hypothermia and impaired temperature homeostasis in the elderly.  Br Med J. 1977;  1 353-356
  • 5 Collins K J, Easton J C, Belfield-Smith H, Exton-Smith A N, Pluck R A. Effects of age on body temperature and blood pressure in cold environments.  Clin Sci. 1985;  69 465-470
  • 6 Collins K J, Exton-Smith A N. Thermal homeostasis in old age.  J Am Geriatr Soc. 1983;  31 519-524
  • 7 Collins K J. Effects of cold on old people.  Br J Hosp Med. 1987;  38 506-514
  • 8 Cooper K E, Ferguson A V. Thermoregulation and hypothermia in the elderly. In: Pozos RS, Wittmers LE eds The Nature and Treatment of Hypothermia. Minneapolis; University of Minnesota Press 1983: 35-45
  • 9 Detry J -MR, Brengelmann G L, Rowell L B, Wyss C. Skin and muscle components of forearm blood flow in directly heated resting man.  J Appl Physiol. 1972;  32 506-511
  • 10 Eurowinter Group . Cold exposure and winter mortality from ischemic heart disease, cerebrovascular disease, respiratory disease, and all causes in warm and cold regions in Europe.  Lancet. 1997;  349 1341-1346
  • 11 Falk B, Bar-Or O, Smolander J, Frost G. Response to rest and exercise in the cold: effects of age and aerobic fitness.  J Appl Physiol. 1994;  76 72-78
  • 12 Florez-Duquet M, McDonald R B. Cold-induced thermoregulation and biological aging.  Physiol Rev. 1998;  78 339-358
  • 13 Fox R H, MacGibbon R, Davies L, Woodward P M. Problem of the old and the cold.  Br Med J. 1973;  1 21-24
  • 14 Frank S M, Raja S N, Bulcao C, Goldstein D S. Age-related thermoregulatory differences during core cooling in humans.  Am J Physiol. 2000;  279 R349-R354
  • 15 Hardy J D. Physiology of temperature regulation.  Physiol Rev. 1961;  41 521-606
  • 16 Heft M W, Cooper B Y, O’Brien K K, Hemp E, O’Brien R. Aging effects on the perception of noxious and non-noxious stimuli applied to the face.  Aging (Milano). 1996;  8 35-41
  • 17 Horvath S M, Radcliffe C E, Hutt B K, Spurr G B. Metabolic responses of old people to a cold environment.  J Appl Physiol. 1955;  8 145-148
  • 18 Horvath S M, Rochelle R D. Hypothermia in the aged.  Environ Health Persp. 1977;  20 127-130
  • 19 Inoue Y, Nakao M, Araki T, Ueda H. Thermoregulatory responses of young and older men to cold exposure.  Eur J Appl Physiol. 1992;  65 492-498
  • 20 Jennings J R, Reynolds III C F, Houck P R, Buysse D J, Hoch C C, Hall F, Monk T H. Age and sleep modify finger temperature responses to facial cooling.  J Gerontol. 1993;  48 M108-M116
  • 21 Keatinge W R. Medical problems of cold weather.  J R Coll Phys. 1986;  20 283-287
  • 22 Keatinge W R, Donaldson G C, Bucher K, Jendritzky G, Cordioli C, Martinelli M, Katsouyanni K, Kunst A E, McDonald C, Näyhä S, Vuori I. Winter mortality in relation to climate.  Int J Circumpolar Health. 2000;  59 154-159
  • 23 Kenney W L, Armstrong C G. Reflex peripheral vasoconstriction is diminished in older men.  J Appl Physiol. 1996;  80 512-515
  • 24 Kenney W L, Buskirk E R. Functional consequences of sarcopenia: effects on thermoregulation.  J Gerontol. 1995;  20A 78-85
  • 25 Kenney W L. Body fluid and temperature regulation as a function of age. In: Gisolfi CV, Lamb DR, Nadel E eds Perspectives in Exercise Science and Sport Medicine: Volume 8: Exercise in Older Adults. Carmel; Cooper Publishing Group 1995: 305-352
  • 26 Kenney W L. Thermoregulation at rest and during exercise in healthy older adults. In: Holloszy JO ed Exercise and Sport Sciences Reviews. Baltimore; Williams & Wilkins 1997 25: 41-76
  • 27 Kenshalo D R Sr. Somesthetic sensitivity in young and elderly humans.  J Gerontol. 1986;  6 732-742
  • 28 Khan F, Spence V A, Belch J JF. Cutaneous vascular responses and thermoregulation in relation to age.  Clin Sci. 1992;  82 521-528
  • 29 Krag C L, Kountz W B. Stability of body function in the aged. I. Effect of the body to cold.  J Gerontol. 1950;  5 227-235
  • 30 Koskela H. Effects of Cold Air on Lung Function in Obstructive Lung Diseases. The Roles of Direct Airway Effects and Cutaneous Reflex Mechanisms. Kuopio University Publications D. Medical Sciences 120. Kuopio; Kuopio University Printing Office 1997
  • 31 Lautenbacher S, Strian F. Similarities in age differences in heat pain perception and thermal sensitivity.  Funct Neurol. 1991;  6 129-135
  • 32 LeBlanc J, Cote J, Dulac S, Dulong-Turcot F. Effects of age, sex, and physical fitness on responses to local cooling.  J Appl Physiol. 1978;  44 813-817
  • 33 Mathew L, Purkayastha S S, Singh R, Sen Gupta J. Influence of aging in the thermoregulatory efficiency of man.  Int J Biometeor. 1986;  30 137-145
  • 34 Mercer J, Sparr S, Leppäluoto J. Proceedings from a seminar “Old and cold”. Understanding excess winter mortality in the elderly.  Int J Circumpolar Health. 2000;  59 149-284
  • 35 Merchut M P, Toleikis S C. Aging and quantitative sensory thresholds.  Electromyogr Clin Neurophysiol. 1990;  30 293-297
  • 36 Millqvist E, Bengtsson U, Bake B. Occurrence of breathing problems induced by cold climate in asthmatics - a questionnaire survey.  Eur Respir J. 1987;  71 444-449
  • 37 Neild P J, Syndercombe-Court D, Keatinge W R, Donaldson G C, Mattock M, Caunee M. Cold-induced increases in erythrocyte count, plasma cholesterol and plasma fibrinogen of elderly people without comparable rise in protein C or factor X.  Clin Sci. 1994;  86 43-48
  • 38 O’Hanlon J F, Horvath S M. Changing physiological relationships in men under acute cold stress.  Can J Physiol Pharmacol. 1970;  48 1-10
  • 39 Ohnaka T, Tochihara Y, Tsuzuki K, Nagai Y, Tokuda T, Kawashima Y. Preferred temperature of the elderly after cold and heat exposures determined by individual self-selection of air temperature.  J Therm Biol. 1993;  18 349-353
  • 40 Petrella R J, Cunningham D A, Nichol P M, Thayer R. Cardiovascular responses to facial cooling are age and fitness dependent.  Med Sci Sports Exerc. 1998;  31 1163-1168
  • 41 Poehlman E T, Danforth Jr E. Endurance training increases metabolic rate and norepinephrine appearance rate in older individuals.  Am J Physiol. 1991;  261 E233-E239
  • 42 Poehlman E T, Arciero P J, Goran M I. Endurance exercise in aging humans: effects on energy metabolism. In: Holloszy JO ed Exercise and Sport Sciences Reviews. Baltimore; William & Wilkins 1994 22: 251-284
  • 43 Pratley R, Nicklas B, Rubin M, Miller J, Smith A, Smith M, Hurley B, Goldberg A. Strength training increases resting metabolic rate and norepinephrine levels in healthy 50- to 65-yr-old men.  J Appl Physiol. 1994;  76 133-137
  • 44 Richardson D, Tyra J, McCray A. Attenuation of the cutaneous vasoconstrictor response to cold in elderly men.  J Gerontol. 1992;  47 M211-M214
  • 45 Spurr G B, Hutt B K, Horvath S M. The effects of age on finger temperature responses to local cooling.  Am Heart J. 1955;  50 551-555
  • 46 Stevens J C, Choo K K. Temperature sensitivity of the body surface over the life span.  Somatosens Mot Res. 1998;  15 13-28
  • 47 Taylor N A, Allsopp N K, Parkes D G. Preferred room temperature of young vs. aged males: the influence of thermal sensation, thermal comfort, and affect.  J Gerontol A Biol Sci Med Sci. 1995;  50 216-221
  • 48 Tochihara Y, Ohnaka T, Nagai Y, Tokuda T, Kawashima Y. Physiological responses and thermal sensations of the elderly in cold and hot environments.  J Therm Biol. 1993;  18 355-361
  • 49 Wagner J A, Horvath S M, Kitagawa K, Bolduan N W. Comparisons of blood and urinary responses to cold exposures in young and older men and women.  J Gerontol. 1987;  42 173-179
  • 50 Wagner J A, Horvath S M. Cardiovascular reactions to cold exposures differ with age and gender.  J Appl Physiol. 1985;  58 187-192
  • 51 Wagner J A, Horvath S M. Influences of age and gender on human thermoregulatory responses to cold exposures.  J Appl Physiol. 1985;  58 180-186
  • 52 Wagner J A, Robinson S, Marino R P. Age and temperature regulation of humans in neutral and cold environments.  J Appl Physiol. 1974;  37 562-565
  • 53 Watts A J. Hypothermia in the aged: a study of the role of cold-sensitivity.  Env Res. 1971;  5 119-126
  • 54 Woodhouse P, Keatinge W R, Coleshaw S RK. Factors associated with hypothermia in patients admitted to a group of inner city hospitals.  Lancet. 1989;  2 120-125
  • 55 Young A J, Lee T K. Aging and human cold tolerance.  Exp Aging Res. 1997;  23 45-67
  • 56 Young A J. Effects of aging on human cold tolerance.  Exp Aging Res. 1991;  17 205-213

Dr. J. Smolander

ORTON Research Institute

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