Thermoregulation and Heat Stroke Prevention in Older Adults: Advances in Emerging Technologies and Interventions.

This systematic review explores interventions and technologies aimed at assessing or improving thermoregulation in older adults (≥60 years) across community, clinical, and institutional settings. Following PRISMA guidelines, a comprehensive search in PubMed, Scopus, Web of Science, and ScienceDirect (2010-2025) identified 449 records, of which nine studies met inclusion criteria. The evidence revealed that thermoregulation in older adults is influenced by complex interactions between environmental, physiological, behavioral, and cognitive factors. Predictive models based on skin or facial temperature, and supported by machine learning approaches, showed promising accuracy in estimating thermal sensation and core temperature. Active interventions, such as cooling devices, ventilated clothing, and microclimatic systems, demonstrated significant reductions in skin and core temperature, improving thermal comfort. Educational and community-based strategies also proved effective in reducing thermal risk perception and adverse events. However, despite the availability of wearable devices capable of continuous monitoring, no studies have reported their application in daily-life or environmental contexts for heatstroke prevention in older adults. This gap highlights a critical opportunity for integrating wearable technologies into preventive frameworks. Future research should focus on validating these approaches in ecological settings and tailoring strategies to individual vulnerabilities, thereby improving thermal safety, autonomy, and well-being in this vulnerable population.