Age UK Research briefing: Winter 2012/13

Winter can be deadly for older people

This winter as many as 25,000 older people could die needlessly because of the cold. That's around 200 preventable deaths a day.(i)

Age UK's Spread the Warmth campaign aims to tackle this shocking situation by raising awareness of the plight of older people in winter and providing practical help and support to change lives.

As part of this, Age UK Research brings you crucial insight into the facts and figures about how winter affects older people. Below you will find statistics, expert commentary, details of related research projects and available case studies.

To arrange any interviews contact Andrew Walker in the Age UK Media Team on 020 3033 1433.

The facts
- Last winter there were 21,700 excess winter deaths of people aged 65 and over in England and Wales.(ii)

- The effect of cold homes has been calculated to cost the NHS in England £1.36 billion annually.(iii)

- Even in relatively mild winters, there are around 8,000 extra deaths for every one degree drop in average temperature.(iv)

- Even in very cold countries such as Norway, excess winter deaths are much lower because of the precautions they take against cold weather.(v)

- In the Russian city of Yakutsk, the coldest city in the world, there is no excess winter mortality.(vi)

The reasons for cold related illness and mortality are varied. Factors such as poor insulation and heating of houses as well as low indoor temperature have a strong relationship with excess winter deaths of older people:(vii)  

- Deaths from hypothermia are rare, however cold weather and poor heating can contribute to the deaths caused by circulatory diseases, which are responsible for nearly half (41%) of all recorded deaths by natural causes.(viii)

- In fact it has been observed that following a cold snap, there are peaks in heart attacks two to three days later, with a peak in strokes five days later and deaths from respiratory illness 12 days later.

Other risks that come as a result of winter include hazardous conditions which can lead to serious injury as a result of falls:

- About a third of all people aged over 65 fall each year (which is equivalent to over 3 million),(ix) with falls representing over half of hospital admissions for accidental injury.(x)

The Met Office has mapped falls against weather (ice, snow) which Age UK has access to.

Ask the expert
Professor James Goodwin, Head of Research at Age UK:
'The winter can cause misery, avoidable illness and even death for too many older people - it is completely unacceptable that 21,700 people aged 65+ (in England and Wales) died in unnecessarily last winter.

Experts in physiology have now shown how exposure to cold contributes to the main causes of death, notably heart attack, strokes (caused by clotting) and respiratory illnesses.

The evidence shows that two principal causes of circulatory illness in the winter is the increase in blood pressure, increased work of the heart in response to cold and an increased risk of blood clotting. 

Breathing in cold air not only increases the blood pressure but cools the respiratory passages, reducing body temperature and exacerbating existing conditions such as asthma, bronchitis and COPD, and suppresses the immune system in older people.

Age UK is campaigning to put an end to thousands of older people dying each winter from preventable causes(xi) by calling on all local authorities to recognise the issue as a major health priority and make sure they are doing everything in their power to keep older people warm.

Age UK also funds research to tackle some of the issues relating to ill health in winter, including immune system decline and falls prevention.'

Age UK Research
Age UK funds a wide range of research projects aiming to improve health and wellbeing in later life, including projects aiming to better understand immune system decline and falls prevention - issues that are particularly relevant in winter.

Tackling immune system decline: Researchers at Queen Mary University of London are aiming to improve immunity and restore its function to provide better protection for older people.

The project is looking at innate immunity, which is the body's first line of defence, protecting us against viruses and bacteria.

 It is hoped that restoring innate immunity could improve protection from the direct effects of infections and therefore reduce the severity and duration of infections in older people, which in turn, would reduce hospital admissions.

Falls prevention: Another project the Charity is funding, this time at the University of Liverpool, is looking at the age-related decline in muscle function which can lead to falls.

The project aims to establish why muscles in older people lose the ability to regenerate successfully after damage, with the hope that findings could lead to new interventions which help maintain muscle strength and mobility for longer. In turn this could help to reduce falls amongst people in later life.

The Charity also runs an annual campaign, Falls Awareness Week (17-21 June 2013) which aims to inform older people and their friends, family and carers about the risk of falls and interventions that can be made to help prevent them.

Age UK is analysing for the first time, the trends in winter mortality over the past 100 years, looking with special interest at those over 85. Interestingly, though excess winter deaths fell slightly in the last (mild) winter in those over 65, it rose by nearly 1% in the over 75s and by 7% in the over 85s.(xii) 

Case studies and spokespeople
Age UK has case studies of older people who have had both positive and negative experiences during winter.

The Charity also has expert spokespeople across a range of fields, including medical research, policy and health & wellbeing. The Charity also works with researchers across the country and can provide experts on a range of issues.

For more information on the effects of winter on older people, Age UK funded research, statistics, case studies or spokespeople contact the Andrew Walker in the Age UK Media Team on 020 3033 1433 or email media@ageuk.org.uk.

Spread the Warmth
Age UK and its local and national partners are working to keep older people warm and well in winter through the Spread the Warmth campaign. We're providing social activities and contact for older people, as well as tips on combating the cold at home and outdoors.

We're keeping people warm and safe at home, giving out hot nutritious meals and offering information and advice 365 days a year. We're also calling on the Government to boost the energy efficiency of older people's homes. Act now to Spread the Warmth and help hundreds of thousands of older people.

Older people and their families can call Age UK Advice for free on 0800 169 65 65, where they can also order a free copy of ‘Winter wrapped up' with a free thermometer. 

Alternatively they can visit www.spreadthewarmth.org.uk to download the guide, get more information about the Spread the Warmth campaign and find out where their local Age UK office or shop is.

There are lots of ways to help Age UK Spread the Warmth this winter. People can make a donation simply by calling 0800 169 87 87 or visiting
 www.spreadthewarmth.org.uk.

Notes to editors

Media contact: Andrew Walker
Tel: 020 3033 1433
Out of hours: 07071 243 243

i) Age UK estimate based on ten-year average for excess winter deaths of people aged 65+ in England and Wales (ONS 2012) of 24,279, divided by 121 days of the winter period (Dec-March) rounded from 200.65

ii) Excess Winter Mortality in England and Wales, 2011/12 (Provisional) (ONS, November 2012)

iii) Age UK's calculation based on the method described in South East Regional Public Health Group Factsheet (2009) Health and Winter Warmth. This made use of a calculator produced by the Chartered Institute of Environmental Health to estimate the total cost to the NHS in England arising from cold homes.

Age UK updated their figure (£859 million) using 2011 household numbers estimates for England (Office for National Statistics) and the GDP deflator (from HM Treasury's website) to inflate the estimates to 2011/12 prices.

iv) Addressing Excess Winter Deaths, Help the Aged, 2001 

v) Seasonal variation in incidence of acute myocardial infarction in a sub-Arctic population: the Tromsø Study 1974-2004. Hopstock et al. European Journal of Preventive Cardiology April 2011 vol. 18 no. 2 320-325

vi) Cold related mortalities and protection against cold in Yakutsk, eastern Siberia: observation and interview study. Donaldson et al (1998) BMJ 317:978

vii) The Health Impacts of Cold Homes and Fuel Poverty
 www.marmotreview.org/reviews/cold-homes-and-health-report.aspx

viii) Based on Annual Abstract of Statistics, Office for National Statistics, 2003

ix) Epidemiology of falls. Masud T, Morris RO., Age and Ageing, 30-S4:3-7, 2001

x) London Health Observatory. Accessed 05/10/10, at  www.lho.org.uk/LHO_Topics/Health_Topics/Diseases/AccidentsInjury.aspx

xi) Age UK and its local and national partners are working to keep older people warm and well. We're providing social activities and contact for older people, as well as tips on combating the cold at home and outdoors.

We're keeping people warm and safe at home, giving out hot nutritious meals and offering information and advice 365 days a year. We're also calling on the Government to boost the energy efficiency of older people's homes. Act now to Spread the Warmth and help hundreds of thousands of older people.

xii) Excess Winter Mortality in England and Wales, 2011/12 (Provisional), Table 2