ArticleBMC geriatrics2026
Community-dwelling older persons' level of functional ability and heat-related vulnerability: results from the Heat-Health Action Plan study in Cologne, Germany.
Article in BMC geriatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundClimate change has intensified significantly across the globe in recent decades. Among others, the 65 + age group and those with certain pre-existing illnesses are at risk. To date, functional ability, as proposed in the WHO framework on Ageing and Health, is not addressed in Heat-Health Action Plans (HHAP). Our study aimed to explore the significance of considering the functional ability to identify individuals at risk during episodes of heat in the 65 + age group.
methodsTwo hundred fifty-eight community-dwelling older adults aged 65 + from the Cologne HHAP Study Group (mean age: 74.1, 50.8% female) were assessed in four carefully selected locations representing the city's range in both socioeconomic status (affluent vs. deprived) and objective thermic exposure (less vs. highly heat-impacted). Questionnaire-based, face-to-face interviews were performed covering heat-related areas. Levels of functional ability were assessed using the LUCAS Functional Ability Index (robust, post-robust, pre-frail, frail); care levels (disability) were determined according to the German Medical Advisory Services.
resultsThe distinction between functionally robust (62%) and functionally disadvantaged (38%) participants has a significant impact on identifying heat-related vulnerability which cannot be identified using chronological age groups (65-74: 55%, 75 + : 45%). During heat events, functionally disadvantaged persons perceived higher levels of heat strain (p = 0.005), were more worried about their health (p < 0.001) and perceived significantly more symptoms such as tiredness, headaches or dizziness. Functionally robust participants changed their outdoor mobility significantly less during heat events (p = 0.025) and more often used the internet as an information source about heat warnings (p = 0.005).
conclusionsThis study shows that considering healthy ageing from the perspective of functional ability rather than focusing on chronological age has the potential to more precisely address those community-dwelling older people living with functional decline, frailty or disability who are most vulnerable in heat situations. The measurement of functional ability by screening community-dwelling older people with a self-administered questionnaire on functional resources and risks proved to be a good asset in evaluating persons with high heat-related vulnerability in the heterogeneous older population.
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