The Aging Body's Thermoregulation Challenges
As the body ages, several physiological changes occur that can make an elderly person more susceptible to feeling cold and shivering. These changes impact the body's natural thermostat, making it harder to maintain a stable internal temperature.
Reduced Metabolic Rate
The metabolic rate, or the speed at which the body converts food into energy, naturally slows down with age. Since heat is a byproduct of metabolism, a slower rate means less body heat is generated. This can lead to a constant feeling of being cold and can trigger the shivering response even in moderately cool environments where a younger person would be comfortable.
Loss of Subcutaneous Fat
Subcutaneous fat, the layer of fat located just beneath the skin, acts as a natural insulator, helping to trap heat and keep the body warm. With age, this layer of fat thins, and its distribution shifts. This reduction in insulation allows body heat to escape more easily, increasing sensitivity to cold and prompting involuntary shivering to generate warmth.
Decreased Blood Circulation
Many seniors experience slower or less efficient blood circulation. Blood vessels may become less flexible and blood flow to the extremities, such as the hands and feet, can decrease. Reduced circulation means that less warm blood reaches these areas, causing them to feel cold and potentially triggering a full-body shivering response as the core tries to compensate.
Underlying Medical Conditions
Shivering in an elderly person is not always a simple matter of being cold; it can also be a symptom of a more serious, underlying health issue. It is critical to differentiate between a simple chill and a medical symptom.
Hypothermia
Hypothermia is a dangerous condition that occurs when the body's core temperature drops below 95°F (35°C). Due to the age-related challenges in thermoregulation, seniors are at a higher risk of developing hypothermia. Initial signs can include shivering, but as it worsens, shivering may stop. Other key symptoms include confusion, drowsiness, slurred speech, and a slow, shallow pulse. If hypothermia is suspected, it is a medical emergency.
Infections and Fever
When the body fights an infection, it raises its internal temperature, causing a fever. The sudden spike in temperature can cause a person to feel cold, leading to shivering or 'the chills.' Common infections that can cause this in older adults include urinary tract infections (UTIs), pneumonia, and the flu. In some elderly individuals, confusion or a low-grade fever may be the only initial sign of a serious infection, making shivering a red flag.
Endocrine Disorders
- Hypothyroidism: An underactive thyroid gland, common in older adults, can slow down the body's metabolism significantly, leading to cold intolerance and frequent shivering.
- Diabetes: Poorly managed diabetes can lead to nerve damage (neuropathy) that affects temperature sensation. Low blood sugar (hypoglycemia) can also trigger shaking and shivering.
Neurological Conditions
- Essential Tremor: This common neurological disorder causes involuntary, rhythmic shaking, most often in the hands. It can sometimes be mistaken for shivering, though it differs in that it typically worsens with movement or stress.
- Parkinson's Disease: Tremors are a hallmark symptom of Parkinson's, and can be more pronounced when the person is at rest. These can be confused with shivering, but are distinct from the full-body muscular contractions of a chill.
Medications and Post-Surgical Shivering
Certain medications and medical procedures can also be responsible for shivering in older adults.
Medication Side Effects
Many medications can cause sensitivity to cold or induce tremors as a side effect. Common culprits include beta-blockers for blood pressure, certain antidepressants, and some asthma medications. Caregivers should be aware of a loved one's medications and any associated side effects.
Postanesthetic Shivering
Shivering is a very common side effect in patients recovering from general anesthesia. Operating rooms are cool, and anesthesia disrupts the body's ability to regulate temperature, causing a drop in core body heat. This is a normal and expected part of the recovery process, but it can be more pronounced and prolonged in older adults due to their already compromised thermoregulation.
Comparison of Causes for Shivering in the Elderly
To help identify the potential cause of shivering, this table compares different scenarios and their typical characteristics. For medical advice, it's always best to consult a healthcare professional. For more information on health issues in seniors, visit the National Institute on Aging website.
| Cause | Key Indicators | Accompanying Symptoms | Recommended Action |
|---|---|---|---|
| Cold Environment | Shivering starts when exposed to cold; stops when warmed. | Hands/feet feel cold, no fever or confusion. | Add layers, use blankets, adjust thermostat. |
| Infection/Fever | Shivering precedes or accompanies a fever. | Confusion, headache, fatigue, increased pulse, other flu-like symptoms. | Consult a doctor, monitor temperature. |
| Hypothermia | Shivering may stop as body temperature drops dangerously low. | Slurred speech, confusion, drowsiness, slow/shallow breathing, pale/blue skin. | Call 911 immediately. Move to warm area, remove wet clothes, warm gently. |
| Hypoglycemia | Shaking accompanied by other low blood sugar symptoms. | Sweating, dizziness, heart palpitations, confusion, hunger. | Give a quick-acting source of sugar, monitor blood sugar levels. |
| Essential Tremor | Rhythmic, involuntary shaking, often in the hands. | Usually no fever or other illness symptoms. Exacerbated by stress or caffeine. | Consult a doctor for proper diagnosis and management. |
| Medication Side Effects | Shivering or tremors start after new medication. | Varies by drug. May be accompanied by fatigue or dizziness. | Speak to a healthcare provider about dosage or alternatives. |
At-Home Management and Prevention
For caregivers, proactive measures can prevent shivering and enhance an elderly person's comfort and safety.
- Maintain a Warm Environment: Ensure the home is adequately heated, especially in winter. Keep the thermostat set to a comfortable temperature (around 68–70°F or 20–21°C). Eliminate drafts by sealing windows and doors.
- Layering Clothing: Encourage dressing in layers. Wearing multiple thin layers, including thermal underwear, socks, and sweaters, is more effective than one thick layer. This allows for easier adjustment throughout the day.
- Provide Warm Drinks and Meals: Offer warm beverages like herbal tea, warm water, or broth. Warm, nutritious meals can also help boost metabolism and generate body heat.
- Encourage Gentle Physical Activity: Light exercise, such as walking indoors or gentle stretches, can improve blood circulation and help the body produce heat. Even small movements are beneficial.
Conclusion
Shivering in an elderly person can be caused by a variety of factors, from natural age-related changes to serious underlying health issues. While sometimes a simple sign of being cold, caregivers should always be vigilant and aware of accompanying symptoms. By understanding the potential causes, maintaining a warm environment, and knowing when to seek professional medical help, you can ensure the well-being of the seniors in your care.
