Thermoregulatory responses of young and older men to cold exposure

Impact of tent shade on heat exposures and simulated heat strain for people experiencing homelessness

Concurrent increases in homelessness and heat intensity, duration, and frequency translate to an urban heat risk trap for the unsheltered population. Homelessness is both a driver and consequence of poor health, co-creating distinct geographies with various risk factors that exacerbate heat vulnerability. We tested the efficacy of different tent shadings over identical tents often observed in the Phoenix area (white bedsheet, mylar, tarp, and aluminum foil) and compared them to a control tent (uncovered) and ambient conditions. We monitored all meteorological variables at all six locations, notably Mean Radiant Temperature (MRT). The in-tent microclimate variability was applied to complete statistical and physiological modeling including substance use on heat strain. Findings indicate that tent shadings resulted in significantly lower in-tent MRT during the day (p < 0.05), but exacerbated in-tent thermal risk during the night compared to the control tent and ambient conditions. Furthermore, we found evidence that the temperature metric matters, and using only either MRT or air temperature (Tair) to assess "heat" could lead to inconsistent conclusions about in-tent microclimate. Interactions between shade types and time significantly amplified in-tent thermal risk. Physiological modeling indicates a higher risk of heat strain (core temperature beyond 40˚C) for people using substances. Decision makers should promote testing different heat intervening strategies toward realizing effective means of protecting human life and preventing heat illnesses. This study illuminates the need for an interdisciplinary approach to studying tents as shelters that considers the total heat load with heat strain modeling.

The Influence of Whole-Body Cryotherapy or Winter Swimming on the Activity of Antioxidant Enzymes

The aim of this study was to investigate the effect of a series of 20 whole-body cryotherapy sessions and 20 winter swimming sessions on the level of catalase, glutathione peroxidase and superoxide dismutase. The experimental group consisted of 60 people (30 people received cryotherapy and 30 people swam in cold water). The control group-without intervention: 30 people. Each of the three groups was tested twice. Analyzing the changes in the examined indicators, a statistical increase of CAT was observed in men after the use of WBC, as well as an increase of SOD in women and a decrease of SOD in men after the winter swimming season. Regular WS does not seem to place an excessive burden on the body in terms of intensifying oxidative processes. WS sessions once a week can be recommended as an effective method of improving health by causing positive adaptive changes and strengthening the body's antioxidant barrier. WBC may be used as an adjunct therapy in the treatment of diseases caused by oxidative stress, as it improves the body's antioxidant capacity. Further research is needed to elucidate antioxidant mechanisms in humans and to determine the short- and long-term effects of exposure to WS and WBC.

Prospective comparative analysis of zero-heat-flux thermometer (SpotOn®) compared with tympanic thermometer and bladder thermometer in extremely aged patients undergoing lower extremity orthopedic surgery

Thermoregulation is important for maintaining homeostasis in the body. It can be easily broken under anesthesia. An appropriate method for measuring core body temperature is needed, especially for elderly patients, because the efficiency of thermoregulation gradually decreases with age. Zero-heat-flux (ZHF) thermometry (SpotOn) is an alternative, noninvasive method for continuous temperature monitoring at the skin surface. The aim of this study was to examine the accuracy and feasibility of using the SpotOn sensor in lower extremity orthopedic surgery in elderly patients aged over 80 years by comparing a SpotOn sensor with 2 other reliable minimally invasive methods: a tympanic membrane thermometer and a bladder thermometer. This study enrolled 45 patients aged over 80 years who were scheduled to undergo lower extremity surgery. Body temperature was measured using a SpotOn sensor, a tympanic membrane thermometer and a bladder thermometer. Agreements between the SpotOn sensor and the other 2 methods were assessed using Bland and Altman plots for repeated measures adjusted for unequal numbers of measurements per patient. Compared with bladder temperature, bias and limits of agreement for SpotOn temperature were 0.07°C ± 0.58°C. Compared with tympanic membrane temperature, bias and limits of agreement for SpotOn temperature were -0.28°C ± 0.61°C. The 3M SpotOn sensor using the ZHF method for patients aged over 80 years undergoing lower extremity surgery showed feasible measurement value and sensitivity.

An individualized and multi-segmental bioheat model for predicting local conditions of the human body under various thermal environments

Thermoregulatory bioheat models have attracted the attention of researchers due to their conformity with the basis of human thermal perception. For this reason, various models have been presented, such as simplified thermoregulatory bioheat (STB), individualized thermoregulatory bioheat (ITB), and multi-segmental thermoregulatory bioheat (MSTB). In the present study and based upon previous models, an individual multi-segment thermoregulatory bioheat (IMTB) model has been introduced. In this model, the body is subdivided into 17 segments and 3 layers, with the blood circulatory system consisting of arteries, veins, and superficial veins. Also, IMTB can evaluate the individual parameters effects (such as height, weight, gender, and age) on physiological parameters and active/passive systems. Finally, this new model was evaluated in human thermal response predictions over a wide range of transient and steady-state environmental conditions (5.0< Tair(°C) <50.0, 31.0 < RH (%)<70.0) and various individual characteristics (male and female, 20 < age (years) < 69, 50 Collapse

Key Words

• Blood circulatory system
• Individual characteristics
• Local skin temperature
• Multi-segment
• Thermoregulatory bioheat model
• Transient thermal environment

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MESH Headings Collapse

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Affiliation(s)

Mahdi Afzalian Mechanical Engineering, University of Birjand, Iran.
Seyed Alireza Zolfaghari Mechanical Engineering, University of Birjand, Iran.

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A 3-D virtual human model for simulating heat and cold stress

In this study, we extended our previously developed anatomically detailed three-dimensional (3-D) thermoregulatory virtual human model for predicting heat stress to allow for predictions of heat and cold stress in one unified model. Starting with the modified Pennes bioheat transfer equation to estimate the spatiotemporal temperature distribution within the body as the underlying modeling structure, we developed a new formulation to characterize the spatial variation of blood temperature between body elements and within the limbs. We also implemented the means to represent heat generated from shivering and skin blood flow that apply to air exposure and water immersion. Then, we performed simulations and validated the model predictions with experimental data from nine studies, representing a wide range of heat- and cold-stress conditions in air and water and physical activities. We observed excellent agreement between model predictions and measured data, with average root mean squared errors of 0.2°C for core temperature, 0.9°C for mean skin temperature, and 27 W for heat from shivering. We found that a spatially varying blood temperature profile within the limbs was crucial to accurately predict core body temperature changes during very cold exposures. Our 3-D thermoregulatory virtual human model consistently predicted the body's thermal state accurately for each of the simulated hot and cold environmental conditions and exertional heat stress. As such, it serves as a reliable tool to assess whole body, localized tissue, and, potentially, organ-specific injury risks, helping develop injury prevention and mitigation strategies in a systematic and expeditious manner.NEW & NOTEWORTHY This work provides a new, unified modeling framework to accurately predict the human body's thermal response to both heat and cold stress caused by environmental conditions and exertional physical activity in one mathematical model. We show that this 3-D anatomically detailed model accurately predicts the spatiotemporal temperature distribution in the body under extreme conditions for exposures to air and water and could be used to help design medical interventions and countermeasures to prevent injuries.

Inhibition of a Novel CLK1-THRAP3-PPARγ Axis Improves Insulin Sensitivity

Increasing energy expenditure by promoting "browning" in adipose tissues is a promising strategy to prevent obesity and associated diabetes. To uncover potential targets of cold exposure, which induces energy expenditure, we performed phosphoproteomics profiling in brown adipose tissue of mice housed in mild cold environment at 16°C. We identified CDC2-like kinase 1 (CLK1) as one of the kinases that were significantly downregulated by mild cold exposure. In addition, genetic knockout of CLK1 or chemical inhibition in mice ameliorated diet-induced obesity and insulin resistance at 22°C. Through proteomics, we uncovered thyroid hormone receptor-associated protein 3 (THRAP3) as an interacting partner of CLK1, further confirmed by co-immunoprecipitation assays. We further demonstrated that CLK1 phosphorylates THRAP3 at Ser243, which is required for its regulatory interaction with phosphorylated peroxisome proliferator-activated receptor gamma (PPARγ), resulting in impaired adipose tissue browning and insulin sensitivity. These data suggest that CLK1 plays a critical role in controlling energy expenditure through the CLK1-THRAP3-PPARγ axis.

Thermoregulatory and cardiovascular responses in the elderly towards a broad range of gradual air temperature changes

This study aimed to determine age-related differences in thermoregulatory and cardiovascular responses to a wide range of gradual ambient temperature (T_a) changes. Morphologically matched normotensive elderly and young males participated. The participants wearing only shorts rested during the 3-h experiment. After 30 min of baseline at 28 °C, T_a increased linearly to 43 °C in 30 min (warming) and then gradually decreased to 13 °C in 60 min (cooling). T_a was rewarmed to 28 °C in 30 min (rewarming), and that temperature was maintained for an additional 30 min (second baseline). During the warming phase, there were no age-related differences in blood pressure (BP) and rectal temperature (T_re), despite a significantly lower cutaneous vascular conductance and heart rate in the elderly (P < 0.05). At the end of the cooling phase, systolic blood pressure (SBP) in the elderly was significantly higher than the young (155.8 ± 16.1 and 125.0 ± 12.5 mmHg, P < 0.01). There was a consistent age group difference in SBP during rewarming. Mean skin temperature was significantly lower in the elderly during rewarming (P < 0.05). T_re decreased more in the elderly and was significantly lower at the end of the experiment than the younger participants (36.78 ± 0.34 and 37.01 ± 0.15 °C, P < 0.05). However, there were no age group differences in thermal sensation. In conclusion, even normotensive elderly participants have a greater and more persistent BP response to cold than younger adults, suggesting that the elderly might be at a higher risk of cardiac events during cooling and subsequent rewarming.

Validation of the Stolwijk and Tanabe Human Thermoregulation Models for Predicting Local Skin Temperatures of Older People under Thermal Transient Conditions

Human thermoregulation models can predict human thermal responses to evaluate thermal comfort and help create a healthy environment, while their applicability to older people has not been sufficiently validated. This study aimed to evaluate the performance of the Stolwijk model and the Tanabe model for predicting older people’s mean and local skin temperatures under thermal transient conditions. Eighteen healthy older people were recruited and exposed to transient environments including neutral (26 °C), low-temperature (23 and 21 °C), and high-temperature (29 and 32 °C) conditions. The local skin temperatures of the subjects were measured and compared to predictions of the Stolwijk model and the Tanabe model. The results revealed that the Stolwijk model and the Tanabe model could accurately predict the mean skin temperature of older people under neutral and high-temperature conditions, while their predictive accuracy declined under low-temperature conditions. Increased deviations were observed in the predictions of local skin temperatures for all conditions. This work attempted to provide an understanding of older people’s thermal response characteristics under transient conditions and to inspire the improvement of thermoregulation models for older people.

Can ultra short-term changes in ambient temperature trigger myocardial infarction?

BACKGROUND

Climate change is increasing global average temperatures, as well as the frequency of extreme weather events. Both low and high ambient temperatures have been associated with elevated mortality; however, little is known about the cardiovascular impacts of hourly temperature.

METHODS

We assessed the association between hourly ambient temperature and risk of myocardial infarction (MI) across adult residents of New York State (NYS). We identified cases across NYS hospitals from 2000 to 2015 in the New York Department of Health Statewide Planning and Research Cooperative System dataset, using ICD codes. Hourly ambient temperature was assessed at each patient's residential ZIP code, up to 48 hours prior to MI. We employed a time-stratified case-crossover study design matching case to control periods on hour of day, day of week, month and year.

RESULTS

Of the 791,695 primary MI hospital admissions, 45% were female, the mean (standard deviation; SD) age was 70 (15) years, and 49% of cases occurred among New York City residents. The observed temperature range was -29 °C to 39 °C, with a mean of 10.8 °C (10.5 °C). Temperature in the 6 h preceding the MI was positively associated with risk of MI, across the range of observed temperatures, with null or nearly null associations for earlier hours. We estimated a cumulative percent increase in hourly myocardial infarction rate of 7.9% (95% confidence interval [CI]: 5.2%, 10.6%) for an 11 °C (median) to 27 °C (95th percentile) temperature increase for lag hours 0-5. Men, Medicare-ineligible individuals (age < 65), and those experiencing their first MI were most sensitive.

CONCLUSION

Our study provides evidence that increases in hourly ambient temperature can trigger myocardial infarction. Health-based definitions of extreme heat events may better capture the deleterious effects of heat by accounting for hourly temperature. Our findings can inform the design of more effective preparedness strategies for the increasingly frequent extreme heat events.

What is cold-related mortality? A multi-disciplinary perspective to inform climate change impact assessments

BACKGROUND

There is a growing discussion regarding the mortality burdens of hot and cold weather and how the balance between these may alter as a result of climate change. Net effects of climate change are often presented, and in some settings these may suggest that reductions in cold-related mortality will outweigh increases in heat-related mortality. However, key to these discussions is that the magnitude of temperature-related mortality is wholly sensitive to the placement of the temperature threshold above or below which effects are modelled. For cold exposure especially, where threshold effects are often ill-defined, choices in threshold placement have varied widely between published studies, even within the same location. Despite this, there is little discussion around appropriate threshold selection and whether reported associations reflect true causal relationships - i.e. whether all deaths occurring below a given temperature threshold can be regarded as cold-related and are therefore likely to decrease as climate warms.

OBJECTIVES

Our objectives are to initiate a discussion around the importance of threshold placement and examine evidence for causality across the full range of temperatures used to quantify cold-related mortality. We examine whether understanding causal mechanisms can inform threshold selection, the interpretation of current and future cold-related health burdens and their use in policy formation.

METHODS

Using Greater London data as an example, we first illustrate the sensitivity of cold related mortality to threshold selection. Using the Bradford Hill criteria as a framework, we then integrate knowledge and evidence from multiple disciplines and areas- including animal and human physiology, epidemiology, biomarker studies and population level studies. This allows for discussion of several possible direct and indirect causal mechanisms operating across the range of 'cold' temperatures and lag periods used in health impact studies, and whether this in turn can inform appropriate threshold placement.

RESULTS

Evidence from a range of disciplines appears to support a causal relationship for cold across a range of temperatures and lag periods, although there is more consistent evidence for a causal effect at more extreme temperatures. It is plausible that 'direct' mechanisms for cold mortality are likely to occur at lower temperatures and 'indirect' mechanisms (e.g. via increased spread of infection) may occur at milder temperatures.

CONCLUSIONS

Separating the effects of 'extreme' and 'moderate' cold (e.g. temperatures between approximately 8-9 °C and 18 °C in the UK) could help the interpretation of studies quoting attributable mortality burdens. However there remains the general dilemma of whether it is better to use a lower cold threshold below which we are more certain of a causal relationship, but at the risk of under-estimating deaths attributable to cold.

Human cold stress of strong local-wind "Hijikawa-arashi" in Japan, based on the UTCI index and thermo-physiological responses

We investigated the cold stress caused by a strong local wind called "Hijikawa-arashi," through in situ vital measurements and the Universal Thermal Climate Index (UTCI). This wind is a very interesting winter phenomenon, localized in an area within 1 km of the seashore in Ozu City, Ehime Prefecture in Japan. When a strong Hijikawa-arashi (HA) occurred at 14-15 m s^-1, the UTCI decreased to - 30 °C along the bridge where commuting residents are the most exposed to strong and cold winds. On the bridge, most participants in our experiment felt "very cold" or "extremely cold." The UTCI of HA can be predicted from a multiple regression equation using wind speed and air temperature. The cold HA wind is also harmful to human thermo-physiological responses. It leads to higher blood pressure and increased heart rate, both of which act as cardiovascular stress triggers. Increases of 6-10 mmHg and 3-6 bpm for every 10 °C reduction in UTCI were seen on all observational days, including HA and non-HA days. In fact, the participants' body skin temperatures decreased by approximately 1.2 to 1.7 °C for every 10 °C reduction in UTCI. Thus, the UTCI variation due to the HA outbreak corresponded well with the cold sensation and thermo-physiological responses in humans. This result suggests that daily UTCI monitoring enables the prediction of thermo-physiological responses to the HA cold stress.

Hypothermia as a risk factor for Alzheimer disease

Alzheimer disease (AD), which is associated with chronic and progressive neurodegeneration, is the most prevalent cause of dementia linked to aging. Among the risk factors for AD, age stands as the greatest one, with the vast majority of people with AD being 65 years of age or older. Nevertheless, the pathophysiologic mechanisms underlying the link between aging and the development of AD, although not completely understood, might reveal important aspects for the understanding of this pathology. Thus, there is significant evidence that the impaired thermal homeostasis associated with normal aging leads to a variety of metabolic changes that could be associated with AD development. In this chapter, we assess the clinical and biochemical evidence implicating hypothermia as a risk factor for the development of AD and the impact of hypothermia on the two pathologic hallmarks of AD: accumulation of senile plaques of amyloid-beta and neurofibrillary tangles of aberrant hyperphosphorylated tau protein.

Thermoregulation and age

The thermoregulatory functions may vary with age. Thermosensitivity is active in neonates and children; both heat production and heat loss effector mechanisms are functional but easily exhaustable. Proportional and lasting defense against thermal challenges is difficult, and both hypothermia and hyperthermia may easily develop. Febrile or hypothermic responses to infections or endotoxin can also develop, together with confusion. In small children febrile convulsions may be dangerous. In old age the resting body temperature may be lower than in young adults. Further, thermosensitivity decreases, the thresholds for activating skin vasomotor and evaporative responses or metabolism are shifted, and responses to thermal challenges are delayed or insufficient: both hypothermia and hyperthermia may develop easily. Infection-induced fevers are often limited or absent, or replaced by hypothermia. Various types of brain damage may induce special forms of hypothermia, hyperthermia, or severe fever. Impaired mental state often accompanies hypothermia and hyperthermia, and may occasionally be a dominant feature of infection (instead of the most commonly observed fever). Aging brings about a turning point in women's life: the menopause. The well-known influence of regular hormonal cycles on the thermoregulation of a woman of fertile age gives way to menopausal hot flushes caused by estrogen withdrawal. Not all details of this thermoregulatory anomaly are fully understood yet.

Impact of improved insulation and heating on mortality risk of older cohort members with prior cardiovascular or respiratory hospitalisations

OBJECTIVES

We carried out an evaluation of a large-scale New Zealand retrofit programme using administrative data that provided the statistical power to assess the effect of insulation and/or heating retrofits on cardiovascular and respiratory-related mortality in people aged 65 and over with prior respiratory or circulatory hospitalisations.

DESIGN

Quasi-experimental cohort study based on administrative data.

SETTING

New Zealand.

PARTICIPANTS

From a larger study cohort of over 900 000 people, we selected two subcohorts: 3287 people who were aged 65 and over and had experienced pretreatment period cardiovascular-related hospitalisation (ICD-10 chapter 9), and 1561 people aged 65 and over who had experienced pretreatment respiratory-related hospitalisation (ICD-10 chapter 10).

INTERVENTIONS

Treatment group individuals lived in a home that received insulation and/or heating retrofits under the Warm Up New Zealand: Heat Smart programme. Control group individuals lived in a home that was matched to a treatment home based on physical characteristics and location.

PRIMARY AND SECONDARY OUTCOME MEASURES

HR for all-cause mortality for treatment with insulation, heating, or insulation and heating relative to control group.

RESULTS

People with pretreatment circulatory hospitalisation who occupied a household that received only insulation had an HR for all-cause mortality of 0.673 (95% CI 0.535 to 0.847) (p<0.001) relative to control group members. Individuals with a pretreatment respiratory hospitalisation who occupied a household that received only an insulation retrofit had an HR for all-cause mortality of 0.830 (95% CI 0.655 to 1.051) (p=0.122) relative to control group members. There was no evidence of an additional benefit from receiving heating.

CONCLUSIONS

We interpret the hazard rate observed for cardiovascular subcohort individuals who received insulation as evidence of a protective effect, reducing the risk of mortality for vulnerable older adults. There is suggestive evidence of a protective effect of insulation for the respiratory subcohort.

Developing a new individualized 3-node model for evaluating the effects of personal factors on thermal sensation

Individual differences, such as weight, height, gender, age, and Basal Metabolic Rate (BMR), between human subjects can significantly affect body thermoregulatory mechanisms. Therefore, application of common population-based thermal comfort models cannot provide accurate results for an individual's thermal sensation. Based on the standard thermal models, including those of Fanger and Gagge, individual parameters are not considered in the evaluation of thermal sensations. Thus, these simplified standard models have some limitations under varied individual conditions. In this study, a new individualized thermal comfort model is presented on the basis of a simplified 3-node model. This model was developed by regarding the effects of individual characteristics, such as age, gender, Body Mass Index (BMI), and BMR on the thermal sensations of the bare and clothed parts of the body. A good agreement was found in the current model, which was verified based on the experimental data. In conclusion, the results indicated that the mean error in the prediction of skin temperature decreased from 1.2°C to 0.4°C when using the new individual model instead of a non-individualized 3-node model.

The Co-chaperone BAG2 Mediates Cold-Induced Accumulation of Phosphorylated Tau in SH-SY5Y Cells

Inclusions of phosphorylated tau (p-tau) are a hallmark of many neurodegenerative disorders classified as "tauopathy," of which Alzheimer's disease is the most prevalent form. Dysregulation of tau phosphorylation disrupts neuron structure and function, and hyperphosphorylated tau aggregates to form neurotoxic inclusions. The abundance of ubiquitin in tau inclusions suggests a defect in ubiquitin-mediated tau protein degradation by the proteasome. Under the temperature of 37 °C, the co-chaperone BAG2 protein targets phosphorylated tau for degradation via by a more-efficient, ubiquitin-independent pathway. In both in vivo and in vitro studies, cold exposure induces the accumulation of phosphorylated tau protein. The SH-SY5Y cell line differentiates into neuron-like cells on treatment with retinoic acid and is an established model for research on the effects of cold on tau phosphorylation. The aim of the present study was to investigate whether BAG2 mediates the cold-induced accumulation of phosphorylated tau protein. Our findings show that cold exposure causes a decrease in BAG2 expression in undifferentiated cells. Conversely, BAG2 expression is increased in differentiated cells exposed to cold. Further, undifferentiated cells exposed to cold had an increased proportion of p-tau to total tau, suggesting an accumulation of p-tau that is consistent with decreased levels of BAG2. Overexpression of BAG2 in cold-exposed undifferentiated cells restored levels of p-tau to those of 37 °C undifferentiated control. Interestingly, although BAG2 expression increased in differentiated cells, this increase was not accompanied by a decrease in the proportion of p-tau to total tau. Further, overexpression of BAG2 in cold exposed differentiated cells showed no significant difference in p-tau levels compared to 37 °C controls. Taken together, these data show that expression of BAG2 is differently regulated in a differentiation-dependent context. Our results suggest that repression of BAG2 expression or BAG2 activity by cold-sensitive pathways, as modeled in undifferentiated and differentiated cells, respectively, may be a causal factor in the accumulation of cytotoxic hyperphosphorylated tau protein via restriction of BAG2-mediated clearance of cellular p-tau.

Sympathetic regulation during thermal stress in human aging and disease

Humans control their core temperature within a narrow range via precise adjustments of the autonomic nervous system. In response to changing core and/or skin temperature, several critical thermoregulatory reflex effector responses are initiated and include shivering, sweating, and changes in cutaneous blood flow. Cutaneous vasomotor adjustments, mediated by modulations in sympathetic nerve activity (SNA), aid in the maintenance of thermal homeostasis during cold and heat stress since (1) they serve as the first line of defense of body temperature and are initiated before other thermoregulatory effectors, and (2) they are on the efferent arm of non-thermoregulatory reflex systems, aiding in the maintenance of blood pressure and organ perfusion. This review article highlights the sympathetic responses of humans to thermal stress, with a specific focus on primary aging as well as impairments that occur in both heart disease and type 2 diabetes mellitus. Age- and pathology-related changes in efferent muscle and skin SNA during cold and heat stress, measured directly in humans using microneurography, are discussed.

Temperature and toxic Tau in Alzheimer's disease: new insights

Alzheimer's disease (AD), the most common dementia in the elderly, is characterized by cognitive impairment and severe autonomic symptoms such as disturbance in core body temperature (Tc), which may be predictors or early events in AD onset. Inclusions of phosphorylated Tau (p-Tau) are a hallmark of AD and other neurodegenerative disorders called “Tauopathies.” Animal and human studies show that anesthesia augments p-Tau levels through reduction of Tc, with implications for AD. Additionally, hypothermia impairs memory and cognitive function. The molecular networks related to Tc that are associated with AD remain poorly characterized. Under physiological conditions, Tau binds microtubules, promoting their assembly and stability. The dynamically regulated Tau-microtubule interaction plays an important role in structural remodeling of the cytoskeleton, having important functions in neuronal plasticity and memory in the hippocampus. Hypothermia-induced increases in p-Tau levels are significant, with an 80% increase for each degree Celsius below normothermic conditions. Although the effects of temperature on Tau phosphorylation are evident, its effects on p-Tau degradation remain poorly understoodWe review information concerning the mechanisms of Tau regulation of neuron plasticity via its effects on microtubule dynamics, with focus on pathways regulating the abundance of phosphorylated Tau species.  We highlight the effects of temperature on molecular mechanisms influencing the development of Tau-related diseases. Specifically, we argue that cold might preferentially affects central nervous system structures that are highly reliant upon plasticity, such as the hippocampus, and that the effect of cold on Tau phosphorylation may constitute a pathology-initiating trigger leading to neurodegeneration.

Elderly bioheat modeling: changes in physiology, thermoregulation, and blood flow circulation

A bioheat model for the elderly was developed focusing on blood flow circulatory changes that influence their thermal response in warm and cold environments to predict skin and core temperatures for different segments of the body especially the fingers. The young adult model of Karaki et al. (Int J Therm Sci 67:41-51, 2013) was modified by incorporation of the physiological thermoregulatory and vasomotor changes based on literature observations of physiological changes in the elderly compared to young adults such as lower metabolism and vasoconstriction diminished ability, skin blood flow and its minimum and maximum values, the sweating values, skin fat thickness, as well as the change in threshold parameter related to core or skin temperatures which triggers thermoregulatory action for sweating, maximum dilatation, and maximum constriction. The developed model was validated with published experimental data for elderly exposure to transient and steady hot and cold environments. Predicted finger skin temperature, mean skin temperature, and core temperature were in agreement with published experimental data at a maximum error less than 0.5 °C in the mean skin temperature. The elderly bioheat model showed an increase in finger skin temperature and a decrease in core temperature in cold exposure while it showed a decrease in finger skin temperature and an increase in core temperature in hot exposure.

Winter-swimming as a building-up body resistance factor inducing adaptive changes in the oxidant/antioxidant status

The aim of our research was to examine whether winter-swimming for five consecutive months results in adaptational changes improving tolerance to stress induced by exposure to cryogenic temperatures during whole-body cryostimulation (WBC). The research involved 15 healthy men, with normal bodyweight, who had never been subjected to either WBC or cold water immersion. During the experiment, the participants were twice subjected to WBC (3 min/- 130°C), namely before the winter-swimming season and after the season. Blood was taken seven times: In the morning before each cryostimulation, 30 min after each cryostimulation and the next morning. Additionally, control blood was collected in the middle of the winter season, in February. Our analysis concerned changes in hematological parameters as well as in reduced glutathione and oxidized glutathione, total oxidant status, total antioxidant status and in components of the antioxidant system: Superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, glutathione S-transferase and 8-Isoprostanes as a sensitive indicator of oxidative stress. We found significant changes in hemoglobin concentration, the number of red blood cells, the hematocrit index and mean corpuscular volume of red blood cell and the percentage of monocytes and granulocytes after the winter swimming season. The response to cryogenic temperatures was milder after five months of winter-swimming. The obtained results may indicate positive adaptive changes in the antioxidant system of healthy winter-swimmers. These changes seem to increase the readiness of the human body to stress factors.

Effects of season on sleep and skin temperature in the elderly

The effects of season on sleep and skin temperature (Tsk) in 19 healthy, elderly volunteers were investigated. Measurements were obtained in summer, winter, and fall, and activity levels were monitored using a wrist actigraph system for five consecutive days. The temperature and humidity of the bedrooms of the subjects' homes were measured continuously for five days. During actigraphic measurement, Tsk during sleep was measured for two nights. The bedroom temperature and humidity significantly increased in summer compared to winter and fall. In summer, the total sleep time decreased (mean +/- SE min; summer, 350.8 +/- 15.7; winter, 426.5 +/- 14.2; fall, 403.2 +/- 16.4) and wakefulness increased (P < 0.003) compared to those in fall or winter. The sleep efficiency index that was derived from wrist actigraphy was significantly decreased (P < 0.001) in summer (81.4 +/- 2.9%) compared with winter (91.6 +/- 1.3%) or fall (90.2 +/- 1.2%). The forehead Tsk significantly increased, while the chest and thigh Tsks were decreased in summer compared to those in fall or winter. These results suggest that, in the elderly, sleep is disturbed in summer more than in other seasons, and that this disturbance is related to fluctuations in Tsk.

Aging affects the cardiovascular responses to cold stress in humans

Cardiovascular-related mortality peaks during cold winter months, particularly in older adults. Acute physiological responses, such as increases in blood pressure, in response to cold exposure may contribute to these associations. To determine whether the blood pressure-raising effect (pressor response) of non-internal body temperature-reducing cold stress is greater with age, we measured physiological responses to 20 min of superficial skin cooling, via water-perfused suit, in 12 younger [25 +/- 1 (SE) yr old] and 12 older (65 +/- 2 yr old) adults. We found that superficial skin cooling elicited an increase in blood pressure from resting levels (pressor response; P < 0.05) in younger and older adults. However, the magnitude of this pressor response (systolic and mean blood pressure) was more than twofold higher in older adults (P < 0.05 vs. younger adults). The magnitude of the pressor response was similar at peripheral (brachial) and central (estimated in the aorta) measurement sites. Regression analysis revealed that aortic pulse wave velocity, a measure of central arterial stiffness obtained before cooling, was the best predictor of the increased pressor response to superficial skin cooling in older adults, explaining approximately 63% of its variability. These results indicate that there is a greater pressor response to non-internal body temperature-reducing cold stress with age in humans that may be mediated by increased levels of central arterial stiffness.

Temperature-dependent association between mortality rate and carbon monoxide level in a subtropical city: Kaohsiung, Taiwan

The objective of this study was to explore the combined effect of temperature and air pollutant levels on daily non-accidental deaths and cardiovascular causes of mortality. In this study, associations were assessed by means of time-series analyses over the period 1995-1999 for Kaohsiung, Taiwan's largest industrial city, which has a subtropical climate. Ambient exposures to various air pollutants, including carbon monoxide (CO), sulfur dioxide (SO(2)), ozone (O(3)), nitrogen dioxide (NO(2)), and particulate matter (PM(10)), were estimated from the arithmetic means of all daily measurements taken by an air quality monitoring station nearest to the residential district. Generalized additive models with non-parametric spline were used to identify associations between daily mortality and air pollutants as well as the air pollutant-temperature interaction correlation. Our findings indicate that CO is associated with increased risks of non-accidental and cardiovascular mortality. For a 0.2 ppm increase in CO, the increased relative daily risk of non-accidental death is at least 4% on the same day, when the mean temperature is above 24.8 degrees C, while the increased relative risk of mortality due to cardiovascular diseases is 7% two days later at 19.7 degrees C. The study also suggests a statistically significant interaction between CO concentration and daily mean temperature, with non-accidental mortality increasing with a warm outdoor temperature and the effect of CO on cardiovascular mortality being modified by a cold climate. Further reduction of CO pollution is thus deemed crucial for the benefit of public health.

Does wearing thermal underwear in mild cold affect skin temperatures and perceived thermal sensation in the hands and feet of the elderly?

The present study was to investigate whether increasing thermal insulation affects thermal sensation in the hands and feet; and whether aging is an influential factor in the relationship between thermal responses and subjective thermal perceptions. Six young males (YM), 5 young females (YF), 6 elderly males (OM), and 6 elderly females (OF) volunteered as subjects. Subjects conducted two trials at a constant air temperature of 19 degrees C: One condition included thermal underwear (19CUW) while the other did not (19C). The results showed that (1) rectal temperature (T(re)) did not show any significant differences between conditions with and without thermal underwear. The T(re) of the OF was greater than that of the YF (p<0.05) for the 19C condition, while the young and elderly male groups showed similar values. (2) The hand and foot skin temperatures (T(hand), T(foot)) were greater in the OF than in the YF group for the 19C condition (p<0.001). (3) For overall thermal sensation, the OF group was less sensitive to differences between the 19CUW and 19C condition, when compared with the old male and young groups. (4) For thermal sensation in the hands and feet, the elderly groups were less sensitive than the YF. In particular, all elderly females felt the hands were thermally neutral, even in the 19C condition. (5) Hand thermal sensation for the OF group appeared to be irrelevant to T(hand). (6) Thermal preference of the elderly groups did not change significantly after adding thermal underwear compared to the young group. In conclusion, wearing thermal underwear in mild cold did not affect local skin temperatures and thermal sensation in the hands and feet for the elderly male and female groups. Adding thermal underwear in mild cold affected the hand skin temperature and thermal sensation of the young female group. In particular, elderly females had specific features concerning local skin temperatures and thermal sensations distinguished from elderly males and young groups.

Hyperthermie und Hypothermie

Heat and cold are environmental factors which severely affect the cardiovascular system. An increase in the body core temperature (hyperthermia) from approximately 36.5 to 39 degrees C causes a doubling of the cardiac output. In connection with vasoconstriction in the splanchnic circulation and in skeletal muscle this results in large increases of skin blood flow. The underlying vasodilatation is evoked by reflex regulation of the efferent sympathetic system. While there is a reduction of alpha-adrenergic vasoconstriction, there is also evidence for active sympathetic cholinergic and nitric oxide-dependent vasodilatation. In the presence of risk factors, e.g. age and diabetes, the circulatory adaptation to heat stress may be compromised. During a reduction of the core temperature (hypothermia) there is a reflex adrenergic vasoconstriction (noradrenalin) of the skin. Cardiac output falls below a core temperature of 34 degrees C due to increasing bradycardia. The reflex vasoconstriction following cold exposure may be aggravated at higher ages, which may cause steeper increases of arterial blood pressure. Due to the reflex nature, the regulatory processes are severely compromised during anaesthesia.

Coronary blood flow after cold exposure and the effect of warm-up exercise

BACKGROUND

Cold pressor test (CPT) results indicate that coronary blood flow (CBF) increases after sudden cold exposure. Traditionally, warm-up exercise (WEx) has been recommended before cold exposure; however, the physiologic effects of WEx on CBF have not been elucidated. Therefore, this study was undertaken to evaluate the effect of WEx on CBF after cold exposure.

METHODS

Fifteen healthy young men were enrolled in this study. CBF at the distal left anterior descending coronary artery was assessed by transthoracic Doppler echocardiography at baseline and after CPT. The same measurements were made with WEx and weight-bearing exercise before CPT after a 20-minute recovery period between each measurement. In the CBF velocities, the time-velocity integral of diastolic flow (Dtvi) was measured in addition to blood pressure and heart rate (HR).

RESULTS

The product of Dtvi x HR increased significantly after CPT. Increments in Dtvi x HR after CPT with WEx before CPT were significantly higher than CPT alone (130 +/- 82% vs 68 +/- 37%, P < .05). However, increments in Dtvi x HR after CPT with weight-bearing exercise before CPT were not significantly different from those observed for CPT alone (74 +/- 50% vs 68 +/- 37%, P = not significant).

CONCLUSION

Our study suggests that WEx can augment an increased CBF after cold exposure. This augmentation of CBF increase after cold exposure may help the body meet increased physiologic demands imposed on it by cold exposure. However, this phenomenon was not observed for anaerobic weight-bearing exercise.

Medical considerations in triathlon competition: recommendations for triathlon organisers, competitors and coaches

Competitors in triathlons experience a range of environmental conditions and physiological demands in excess of that found in individual sport events of comparable duration. Consequently, there is a broad range of possible medical problems and complications that must be taken into account when preparing for such races. For most competitors, an Olympic-distance triathlon typically takes between 2-4 hours to complete. This race begins with a swimming segment of 1500 m. Given the wide variety of race venues found around the world, these swims occur in an assortment of water temperatures (from warm to cold) and conditions (from ocean surf to lake calm). Swimmers often exit the water in a state of moderate dehydration and hypothermia and then immediately start the 40 km cycling leg. Many do so in their swimming attire. A wide variety of road surfaces, technically challenging topography, variable environmental conditions and dramatically changing velocities can be encountered on the cycle course. The race concludes with a 10 km running leg. Since it is the final leg, it is often completed in higher ambient temperatures than those encountered at the start, with the athlete possibly running in a significant state of dehydration and fatigue. Other medical problems commonly encountered in triathlon include: muscle cramping, heat illness, postural hypotension, excessive exposure to ultraviolet radiation, musculoskeletal injuries and trauma, gastrointestinal problems as well as post-race bacterial infection, immunosuppression, sympathetic nervous system and psychological exhaustion, and haemolysis. The rate of occurrence of such events and the severity of their potentially negative outcomes is a function of the methods used by both the race organisers and the competitors to prevent or respond to the conditions imposed by the race. Triathletes also commonly compete in both shorter 'sprint distance' events (in the range of a 0.75 km swim, 20 km cycle and 5 km run) and longer events including both one-half and full Ironman distances (2.5 and 3.8 km swim, 80 and 180 km cycle, 20 and 42 km run, respectively), as well as ultra-distance events that exceed the Ironman distance. In the longer events, the previously mentioned medical considerations are further magnified and additional considerations such as hyponatraemia can also occur. Reducing risk associated with these concerns is accomplished by: taking into account weather and water temperature/conditions data prior to event scheduling; effective swim, cycle and run course organisation and management; environmental monitoring prior to and during the event; the implementation of a water safety plan; provision of appropriate fluid replacement throughout the course; implementation of helmet use and non-drafting regulations in the cycling leg; and competitor knowledge regarding fluid replacement, biomechanical technique, physical preparation, safe equipment and course familiarity. Despite these concerns, triathlon participation appears to relatively safe for persons of all ages, assuming that high-risk adults undertake health screening.

Perspectives on environmental adaptability and physiological polymorphism in thermoregulation

The environmental adaptability of human beings has progressed according to various environments experienced in the course of evolution. Therefore, various phenotypes for environmental adaptability exist and are considered to be physiological polymorphism. Physiological polymorphism in thermoregulation is influenced by genotype, individual characteristics, environmental factors, cultural factors, etc. Moreover, it is thought that physiological polymorphism is evidenced more clearly in physiological responses to extreme situations and/or changing conditions than in environments where homeostasis is easily maintained. In the field of physiological anthropology, I think that it is important not only to discover the physiological responses that demonstrate polymorphism, but also to hypothesize about the mechanisms and the processes by which such polymorphisms were formed, and their meaning for human beings. Such discussions may be supposed to lead to an evaluation of the environmental adaptability of humans from the viewpoint of physiological anthropology.

Cutaneous vasoconstrictor responses to norepinephrine are attenuated in older humans

Cutaneous vasoconstriction (VC) in response to cooling is impaired with human aging. On the basis of previous findings that older humans rely predominantly on norepinephrine (NE) for reflex VC of skin blood vessels, and that the VC effects of NE are blunted with age in many vascular beds, we tested the hypothesis that cutaneous VC responses to exogenous NE are attenuated in aged skin compared with young skin. In 11 young (18–30 yr) and 11 older (62–76 yr) men and women, skin blood flow was monitored at two forearm sites with laser Doppler (LD) flowmetry, while local skin temperature was clamped at 34°C. At one site, five doses of NE (10−10 to 10−2 M) were sequentially infused via intradermal microdialysis while the other site served as control (C; Ringer). Cutaneous vascular conductance (CVC; LD flux/mean arterial pressure) was expressed as percent change from baseline (%ΔCVCbase). At 10−10, 10−8, and 10−6 M NE, older VC responses were attenuated compared with young [10−10: −35 (95% confidence interval: −16, −52) vs. −49 (−40, −58) %ΔCVCbase, P = 0.02; 10−8: −38 (−20, −56) vs. −50 (−40, −61) %ΔCVCbase, P = 0.03; 10−6: −52 (−35, −70) vs. −67 (−60, −74) %ΔCVCbase, P = 0.01]. Older maximal VC responses were also blunted compared with young [−80 (confidence interval: −73,−87) vs. −88 (confidence interval: −87, −90) %ΔCVCbase, P = 0.03]. NE-mediated cutaneous VC is blunted at both physiological and superphysiological doses in older subjects compared with young subjects. Considering that NE is the only functional neurotransmitter mediating reflex VC in aged skin, attenuated NE-mediated VC may further predispose older humans to excess heat loss in the cold.

Attenuated noradrenergic sensitivity during local cooling in aged human skin

Reflex-mediated cutaneous vasoconstriction (VC) is impaired in older humans; however, it is unclear whether this blunted VC also occurs during local cooling, which mediates VC through different mechanisms. We tested the hypothesis that the sensitization of cutaneous vessels to noradrenaline (NA) during direct skin cooling seen in young skin is blunted in aged skin. In 11 young (18-30 years) and 11 older (62-76 years) men and women, skin blood flow was monitored at two forearm sites with laser Doppler (LD) flowmetry while local skin temperature was cooled and clamped at 24 degrees C. Cutaneous vascular conductance (CVC; LD flux/mean arterial pressure) was expressed as percentage change from baseline (% DeltaCVC(base)). At one site, five doses of NA (10(-10)-10(-2) m) were sequentially infused via intradermal microdialysis during cooling while the other 24 degrees C site served as control (Ringer solution + cooling). At control sites, VC due to cooling alone was similar in young versus older (-54 +/- 5 versus -56 +/- 3% DeltaCVC(base), P = 0.46). In young, NA infusions induced additional dose-dependent VC (10(-8), 10(-6), 10(-4) and 10(-2) m: -70 +/- 2, -72 +/- 3, -78 +/- 3 and -79 +/- 4% DeltaCVC(base); P < 0.05 versus control). In older subjects, further VC did not occur until the highest infused dose of NA (10(-2) m: -70 +/- 5% DeltaCVC(base); P < 0.05 versus control). When cutaneous arterioles are sensitized to NA by direct cooling, young skin exhibits the capacity to further constrict to NA in a dose-dependent manner. However, older skin does not display enhanced VC capacity until treated with saturating doses of NA, possibly due to age-associated decrements in Ca2+ availability or alpha2C-adrenoceptor function.

Winter swimming: healthy or hazardous? Evidence and hypotheses

Swimming in cold water during the winter season is an extreme sport, with fans all over the world. However, its effects on health have been debated. This article examines the hypothesis that the effects of winter swimming may depend on previous exposure to cold stimuli. Immersion in cold water in unaccustomed persons may lead to detrimental consequences, while, in regular winter swimmers, adaptive physiologic mechanisms increase tolerance to cold. Furthermore, these mechanisms may prevent the occurrence of a wide variety of diseases. Prospective studies and epidemiological data are needed to test this hypothesis.

Altered neurotransmitter control of reflex vasoconstriction in aged human skin

Cutaneous vasoconstriction (VC) in response to cooling is attenuated in older humans; however, mechanisms underlying this functional decline remain unclear. The present study tested the hypothesis that the contributions of noradrenaline (NA) and sympathetic cotransmitters to reflex-mediated cutaneous VC are altered with age. In 11 young (18-26 years) and 11 older (61-77 years) men and women, forearm skin blood flow was monitored at three sites using laser Doppler flowmetry (LDF) while mean skin temperature was lowered from 34 to 30.5 degrees C using a water-perfused suit. Cutaneous vascular conductance (CVC; LDF/mean arterial pressure) was expressed as percentage change from baseline (% DeltaCVC(base)). Solutions of yohimbine + propranolol (Y + P), bretylium tosylate (BT), and lactated Ringer solution were infused via intradermal microdialysis at each LDF site to antagonize alpha- and beta-adrenoceptors, block sympathetic release of NA and cotransmitters, and act as control, respectively. During cooling, VC was attenuated at the control site in older subjects compared to young subjects (-16 +/- 3 versus-34 +/- 4% DeltaCVC(base), P < 0.001). Y + P attenuated VC in young subjects (-13 +/- 8% DeltaCVC(base), P < 0.001 versus control) and abolished VC in older subjects (0 +/- 3% DeltaCVC(base), P > 0.9 versus baseline). BT completely blocked VC in both age groups. Cutaneous VC in young subjects is mediated by both NA and sympathetic cotransmitter(s); however, reflex VC in aged skin is attenuated compared to young and appears to be mediated solely by NA.

Evaluation of the use of an integration-type laser-Doppler flowmeter with a temperature-loading instrument for measuring skin blood flow in elderly subjects during cooling load: comparison with younger subjects

An integration-type laser-Doppler flowmeter, equipped with a temperature-load instrument, for measuring skin blood flow (ILD-T), and analytical parameters developed in a previous study were used to compare changes in the skin blood flow in the forehead and cheek in elderly subjects (in their 60s and 70s) with those in younger subjects (in their teens to 50s). Age-related differences in skin blood flow in the forehead and cheek in response to cooling were evaluated in 90 healthy women in their teens to 70s (mean age: 17.2 +/- 0.33 years for teenagers; 24.3 +/- 0.76 years for those aged 20-29 years; 34.8 +/- 1.12 years for those aged 30-39 years; 43.3 +/- 0.78 years for those aged 40-49 years; 53.8 +/- 1.13 years for those aged 50-59 years; 63.5 +/- 0.55 years for those aged 60-69 years; 72.2 +/- 0.70 years for those aged 70-79 years). The measurement was performed continuously for 5 min: for 1 min at a sensor temperature of 30 degrees C, for 2 min after the setting of the sensor temperature had been changed to 10 degrees C, and for 2 min after the temperature setting had been cancelled. The parameters analyzed were (1) skin temperature in a resting state before measurement ( T(rest)), (2) mean skin blood flow in 1 min at a sensor temperature of 30 degrees C ( F(30 degrees C)), (3) minimum skin blood flow at a sensor temperature of 10 degrees C ( F(min)), (4) slope of the blood flow plot during the period from the beginning of cooling at 10 degrees C to F(min) ( S(fall)), (5) time required for the sensor temperature to reach 10 degrees C (Delta t(s)), (6) maximum skin blood flow during the period from the end of cooling to the end of measurement ( F(max)), (7) slope of the blood flow plot during the period from F(min) to F(max) ( S(rise)), (8) rate of decrease of the skin blood flow during cooling: FDR = ( F(min)/ F(30 degrees C))x100, (9) recovery rate of the skin blood flow after the end of cooling: FRR = ( F(max)/ F(30 degrees C))x100. When correlations among the above nine parameters were evaluated by combining all age groups, significant correlations ( P < 0.01) were observed between F(30 degrees C) and F(min), F(30 degrees C) and F(max), F(30 degrees C) and S(fall), F(min) and F(max), and F(max) and S(rise) in the forehead. In the cheek, significant correlations ( P < 0.01) were observed in all these combinations except between F(max) and S(rise). When these analytical parameters were compared among the age groups, F(30 degrees C), T(rest), F(max), and S(rise) decreased significantly ( P < 0.02 for F(30 degrees C) and T(rest), P < 0.01 for F(max) and S(rise)) and S(fall) increased significantly ( P < 0.03) in the forehead with aging. However, no significant change with aging was observed in FDR, Delta t(s), F(min), and FRR. In the cheek, FDR increased significantly ( P < 0.03), and S(rise) decreased significantly ( P < 0.01) with aging. However, no significant change with aging was observed in F(30 degrees C), T(rest), F(max), S(fall), Delta t(s), F(min), and FRR. Thus, the decrease in the skin blood flow during cooling showed no marked quantitative change with age, but, with aging, the rate of this decrease was clearly reduced in the forehead. In the cheek, on the other hand, the skin blood flow decreased markedly with aging, but no clear change was observed in the rate of this decrease. By using ILD-T and examining various parameters obtained, the skin hemodynamics in the forehead and cheek during cooling from 30 degrees C to 10 degrees C could be analyzed, and differences in the hemodynamics between the forehead and cheek and between elderly and younger individuals were clarified. This instrument is expected to be clinically useful.

Age-related thermoregulatory differences during core cooling in humans

The current study assessed sympathetic neuronal and vasomotor responses, total body oxygen consumption, and sensory thermal perception to identify thermoregulatory differences in younger and older human subjects during core cooling. Cold fluid (40 ml/kg, 4 degrees C) was given intravenously over 30 min to decrease core temperature (Tc) in eight younger (age 18-23) and eight older (age 55-71) individuals. Compared with younger subjects, the older subjects had significantly lower Tc thresholds for vasoconstriction (35.5 +/- 0.3 vs. 36.2 +/- 0.2 degrees C, P = 0.03), heat production (35.2 +/- 0.4 vs. 35.9 +/- 0.1 degrees C, P = 0.04), and plasma norepinephrine (NE) responses (35.0 vs. 36.0 degrees C, P < 0.05). Despite a lower Tc nadir during cooling, the maximum intensities of the vasoconstriction (P = 0.03) and heat production (P = 0.006) responses were less in the older compared with the younger subjects, whereas subjective thermal comfort scores were similar. Plasma NE concentrations increased fourfold in the younger but only twofold in the older subjects at maximal Tc cooling. The vasomotor response for a given change in plasma NE concentration was decreased in the older group (P = 0.01). In summary, aging is associated with 1) a decreased Tc threshold and maximum response intensity for vasoconstriction, total body oxygen consumption, and NE release, 2) decreased vasomotor responsiveness to NE, and 3) decreased subjective sensory thermal perception.

The effect of short-term cold exposure on risk factors for cardiovascular disease

The aim of this study was to see if a short-term period of exposure to cold in young healthy subjects causes changes in hematological factors known to be associated with the promotion of thrombogenesis. Over a period of 48 hours, changes in the distribution of erythrocytes, granulocytes, and blood platelets, as well as several coagulation, inflammatory, and fibrinolytic parameters, were monitored in 11 young healthy male subjects following a short period (1 hour) of cold exposure (CE) (ambient temperature, 11 degrees C) or exposure to thermoneutral conditions (ambient temperature, 26 degrees C) in winter (November). The major findings were: (1) a CE-induced hemoconcentration as indicated by an increase in erythrocyte count (3.2% increase); (2) after appropriate adjustments for changes in hemoconcentration, a cold-induced mobilization of granulocytes (14.5% increase) and a cold-induced decrease in lymphocytes (7% decrease); (3) thromboxane B2 release following endotoxin stimulation of whole blood was increased by 27.4% in the CE experiments; (4) diurnal rhythms were observed in granulocytes, blood platelets, middle plate volume, tissue plasminogen activator, and plasma activator inhibitor; and (5) CE caused no significant changes in lipopolysaccharide-induced tissue factor, nor in the blood coagulation factor VII or cytokines, interleukin-6, and tumor necrosis factor. It is concluded that short-term cold exposure in young healthy subjects initiates a mild inflammatory reaction and a tendency for an increased state of hypercoagulability.

Cold-induced thermoregulation and biological aging

Aging is associated with diminished cold-induced thermoregulation (CIT). The mechanisms accounting for this phenomenon have yet to be clearly elucidated but most likely reflect a combination of increased heat loss and decreased metabolic heat production. The inability of the aged subject to reduce heat loss during cold exposure is associated with diminished reactive tone of the cutaneous vasculature and, to a lesser degree, alterations in the insulative properties of body fat. Cold-induced metabolic heat production via skeletal muscle shivering thermogenesis and brown adipose tissue nonshivering thermogenesis appears to decline with age. Few investigations have directly linked diminished skeletal muscle shivering thermogenesis with the age-related reduction in cold-induced thermoregulatory capacity. Rather, age-related declines in skeletal muscle mass and metabolic activity are cited as evidence for decreased heat production via shivering. Reduced mass, GDP binding to brown fat mitochondria, and uncoupling protein (UCP) levels are cited as evidence for attenuated brown adipose tissue cold-induced nonshivering thermogenic capacity during aging. The age-related reduction in brown fat nonshivering thermogenic capacity most likely reflects altered cellular signal transduction rather than changes in neural and hormonal signaling. The discussion in this review focuses on how alterations in CIT during the life span may offer insight into possible mechanisms of biological aging. Although the preponderance of evidence presented here demonstrates that CIT declines with chronological time, the mechanism reflecting this attenuated function remains to be elucidated. The inability to draw definitive conclusions regarding biological aging and CIT reflects the lack of a clear definition of aging. It is unlikely that the mechanisms accounting for the decline in cold-induced thermoregulation during aging will be determined until biological aging is more precisely defined.

Aging and human cold tolerance

Hypothermia is widely considered to be a more serious threat for older than for younger persons because of older person's impaired ability to defend body temperature during cold exposure. Some epidemiological studies indicate that the incidence of death from hypothermia increases with age, but surveys of body temperature normally maintained by older persons while in their own homes do not indicate a large incidence of hypothermia. More reliable comparisons of thermoregulatory responses to cold stress in younger and older subjects have been performed under controlled conditions in laboratory experiments. Generally, older men appear less able than younger men to defend their core temperature during experimental cold exposures. Cold exposure may elicit a slightly smaller rise in metabolic heat production, and the cutaneous vasoconstrictor response to cold may be less responsive in old than in young men. These aging effects may, however, be limited to men. In a recent study, older women appeared to defend core temperature during cold exposure as well as, or better than, younger women. Preventable changes in body composition and physical fitness rather than aging per se may contribute to impaired thermoregulatory responses to cold observed in older workers.

Clothing microclimate temperatures during thermal comfort in boys, young and older men

To examine the effects of age-related differences in thermoregulatory function on the clothing microclimate temperature (Tm) and Tm fluctuations while maintaining thermal comfort in daily life, 5 boys (group B, 10-11 years), 5 young men (group Y, 20-21 years) and 5 older men (group O, 60-65 years) volunteered to take part in this study. The subjects were asked to maintain thermal comfort as closely as possible in their daily lives. Tm (temperatures between the skin surface and the innermost garment) at four sites (chest, back, upper arm, and thigh), skin temperature on the chest (Tchest) and ambient temperature (Ta) were measured over a period of 8-12 h from morning to evening on one day in each of the seasons, spring, summer, autumn, and winter. Records of ability to maintain thermal comfort and of adjustment of their clothes were kept by each subject. Ta during periods of thermal comfort did not differ among the groups in any of the seasons. In group Y, Tm was significantly lower at the thigh than at the other sites in spring, autumn, and winter (P < 0.05) and fluctuations (CV) of Tm were significantly larger at the thigh than at other sites in autumn and winter (P < 0.05). Similar tendencies were observed for Tm and CV of Tm in group B. However, Tm and CV of Tm in group O did not differ by site except for the autumn Tm. Group O had a smaller CV at the thigh in winter (P < 0.05), compared to groups B and Y, suggesting a smaller regional difference in Tm fluctuation in group O. Group O adjusted their clothes even on the lower limbs (together with upper body) in order to maintain thermal comfort in accordance with changes in Ta, while groups B and Y did so only on their upper bodies. These results suggest that compared to boys and young men, lower thermoregulatory function in older men may affect Tm and CV of Tm as a result of clothing on lower limbs being adjusted differently in order to maintain thermal comfort.

Regional differences in age-related decrements of the cutaneous vascular and sweating responses to passive heating

Ten older (aged 64-76 years) and ten younger (aged 20-24 years) healthy men were exposed to a standard heat stress [by placing the lower legs and feet in a water bath at 42 degrees C while sitting in a controlled environment (ambient temperature 35 degrees C and 45% relative humidity) for 60 min]. During passive heating, the rectal temperature of the older men was significantly greater (P < 0.05) and mean skin temperature was lower (P < 0.001), compared to the younger men. Skin blood flow by laser Doppler flowmetry (LDF) was significantly lower on the chest and thigh for the older men (P < 0.001), but forehead LDF did not differ between the groups. The percentages of total LDF in the older men to total LDF in the younger men for the last 30 min were 99%, 58% and 50% on the forehead, chest and thigh, respectively. The age-related differences in LDF responses mirrored cutaneous vascular conductances (CVC), since no group and time effects were observed in mean arterial blood pressure during the test. During the last 30 min the local sweat rates (msw) on the back and thigh were significantly lower for the older men (P < 0.02), but not on forehead, chest and forearm, although the older men had lower msw during the first 30 min exposure regardless of site (P < 0.03). The percentages of total msw in the older men to total msw in the younger men during the last 30 min were 105%, 99%, 63%, 106% and 88% on the forehead, chest, thigh, forearm, and back, respectively. During the latter half of the exposure, the older men had similar LDF, CVC and msw on the forehead, lower LDF and CVC and a similar msw on the chest, and lower LDF, CVC and msw on the thigh, compared to the younger men. These results suggest firstly that regional differences exist in the age-related decrement of cutaneous vasodilatation as well as sweat gland function, secondly that the age-related decrement in cutaneous vascular function may precede a decrement in sweat gland function, and thirdly that the successive decrements may develop sequentially from the lower limbs to the upper body, and head.

Thermoregulatory responses of prepubertal boys and young men in changing temperature linearly from 28 to 15 degrees C

To examine thermoregulatory responses of prepubertal children to cold stress, 11 boys (aged 8 years) and 11 young men (aged 19-23 years), wearing only trunks, participated in this study. They sat in air at 28 degrees C for 30 min (equilibrium period) and then in conditions where air temperature (Ta) was decreased linearly from 28 to 15 degrees C (at a constant rate of 0.22 degrees C.min-1) for 60 min, at a fixed relative humidity of 65%. In the equilibrium period there was no significant difference between the groups for rectal temperature [Tre, mean 37.30 (SEM 0.10) and mean 37.43 (SEM 0.14) degree C in the boys and the men, respectively] or for the respective skin temperatures (except for the forehead), but metabolic heat production (M) was significantly greater for the boys [mean 57.1 (SEM 1.2) and mean 52.0 (SEM 0.9) W.m-2, P < 0.005]. With declining Ta, the skin temperatures decreased in both groups (P < 0.001), but the decrease was significantly greater for the boys (P < 0.05), especially on the limbs as represented by the thigh and forearm. No significant correlations were observed between the limb skin temperatures compared to surface area-to-mass ratio or limb skinfold thicknesses in either group. The rate of increase in M as Ta decreased was significantly lower for the boys (P < 0.01) largely because of a higher M before the cold exposure. Thus, the mean M during the cold exposure did not differ between the groups [mean 63.6 (SEM 1.1) and mean 61.6 (SEM 1.1) W.m-2 in boys and men, respectively]. When the Ta was lowered, Tre in the boys started falling (P < 0.001), whereas the Tre in the young men did not change for 60 min. The Tre during the 60-min exposure was significantly lower (P < 0.001) for the boys [mean 37.01 (SEM 0.13) and mean 37.48 (SEM 0.18) degree C at the end of the exposure]. It was concluded that when Ta was lowered, the prepubertal boys appeared to vasoconstrict more in their limbs and to be somewhat more hypothermic, compared to the young men.

Seasonal variation in physiological responses to mild cold air in young and older men

Eight men aged 60-65 years and six men aged 20-25 years, wearing only swimming trunks, were exposed to an air temperature of 17 degrees C and 45% R.H. in each of the four seasons. The increase in the rate of metabolic heat production (% delta M) for the older group in the cold test was significantly higher in summer and autumn than in winter and spring (P < 0.05), but did not differ in the young group between seasons. Compared to the young group the % delta M was significantly greater for the older group (due to a marked increase in four individuals) in summer and autumn (P < 0.04). At the end of the period of cold exposure, the decrements of rectal temperature (delta Tre), mean skin temperature (Tsk; due to a marked decrease in four individuals) and foot skin temperature (Tfoot) were significantly greater for the older group compared to the young group at all times of the year (P < 0.003). Seasonal variations in the two groups were similar, e.g., the delta Tre gradually became smaller from summer to winter (P < 0.05) and then increased slightly in the spring (P = 0.07). Tfoot for both groups decreased from summer to autumn (P < 0.01) and remained unchanged subsequently. No seasonal variations were observed for Tsk in either group. The increase in diastolic blood pressure (BPd) during the test was significantly smaller in winter in both groups (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)