Who is likely to get hypothermia? A guide to key risk factors

September 25, 2025 •

4 min read

According to the Centers for Disease Control and Prevention (CDC), hypothermia can occur even at cool temperatures, especially when a person is chilled by rain or sweat. Understanding who is likely to get hypothermia is crucial for proactive prevention and safety awareness, especially for those in vulnerable populations.

Quick Summary

Individuals at the highest risk for hypothermia include the very young and the elderly, people with chronic illnesses, those experiencing homelessness, and individuals under the influence of alcohol or drugs. Environmental exposure and certain medications also increase susceptibility.

Key Points

Extremes of Age are Vulnerable: Infants and older adults have difficulty regulating body temperature, making them especially susceptible to hypothermia, even indoors.
Health Conditions Increase Risk: Chronic illnesses like heart disease, diabetes, and thyroid issues impair the body's ability to stay warm.
Substance Use is Dangerous: Alcohol and drugs impair judgment and the body's natural response to cold, significantly raising hypothermia risk.
Outdoor Exposure is a Major Factor: People spending extended time outdoors, like hikers and the homeless, are at high risk, especially if their clothing gets wet.
Indoor Hypothermia is a Real Threat: Poorly heated homes can cause hypothermia, particularly in older adults, who may not sense the cold as acutely.
Prevention is Key: Simple steps like layering clothing and ensuring adequate indoor heating can prevent a medical emergency.

Understanding the body's struggle against the cold

When the body loses heat faster than it can produce it, hypothermia sets in. This dangerous condition, defined by an abnormally low body temperature, can impair brain function and motor skills, making it hard to seek help. While prolonged exposure to frigid temperatures is a primary cause, many other factors, some surprising, determine an individual's risk. Awareness of these risk factors is the first step in protecting yourself and those around you.

The extremes of age: Infants and older adults

Both infants and the elderly are disproportionately susceptible to hypothermia for distinct physiological reasons.

Infants and young children

Infants have less body fat to insulate them and are less capable of regulating their body temperature compared to adults. They also have a larger skin surface area relative to their body weight, causing them to lose heat more quickly. This risk is not limited to outdoor exposure; a baby sleeping in a cold room is also at risk. Children playing outdoors might also ignore the cold and wet conditions, increasing their exposure time without proper precautions.

Older adults

For the elderly, age-related changes diminish the body's ability to regulate temperature effectively and sense cold. Many older adults also live alone and may have inadequate food, heating, or clothing. Certain medical conditions common in this demographic, such as hypothyroidism and circulatory problems, further elevate the risk. Studies have even shown that even mildly cool indoor temperatures (around 60–65°F) can be dangerous for this population.

Medical conditions and risk factors

Several underlying health issues can interfere with the body's ability to maintain a stable temperature, increasing the likelihood of hypothermia.

Endocrine and metabolic disorders: Conditions like hypothyroidism and diabetes can impair the body's metabolic processes and temperature control.
Cardiovascular disease: Heart and circulation problems can restrict blood flow to the extremities, making it harder for the body to stay warm.
Neurological disorders: Diseases such as Parkinson's and stroke can interfere with movement and judgment, preventing a person from seeking warmth. Individuals with dementia may also wander from home and become lost in cold weather.
Malnutrition and exhaustion: Poor nutrition or severe fatigue reduces the body's energy stores needed to produce heat.

Behavioral and substance-related risks

Impaired judgment due to substances or mental health conditions is a significant risk factor, especially for prolonged exposure.

Alcohol and drug use: Alcohol, contrary to popular belief, causes blood vessels to expand, leading to faster heat loss from the skin's surface. It also dulls the body's natural shivering response and impairs judgment, making an intoxicated person less likely to recognize or respond to the cold.
Mental health conditions: People with mental illness or cognitive impairments may not dress appropriately for the weather or recognize the danger of cold exposure.
Homelessness: People experiencing homelessness often lack adequate shelter, clothing, and heating, leaving them outdoors for extended periods in cold conditions.

Environmental and situational factors

Beyond individual health, external conditions play a huge role in hypothermia risk.

Prolonged outdoor exposure: This includes hikers, hunters, and outdoor workers who may be exposed to cold, wind, and rain for long periods. Getting wet from rain or sweat significantly increases heat loss.
Inadequate indoor heating: For some, hypothermia can occur even indoors if their home is poorly heated. This is especially risky for older adults.
Certain medications: Some prescription and over-the-counter medications, including certain antidepressants, pain medications, and sedatives, can alter the body's temperature regulation.

A comparison of hypothermia risk factors


Risk Factor	Infants/Young Children	Older Adults	Outdoor Workers/Hikers	Substance Users
Body Temperature Regulation	Poorly developed; lose heat quickly due to larger surface area to mass ratio.	Diminished ability due to age; less effective sensing of cold.	Generally healthy, but prolonged exposure can overwhelm defenses.	Impaired by substances like alcohol, which causes vasodilation and heat loss.
Awareness & Judgment	Lack of judgment; may ignore cold while playing.	May have impaired cognition (dementia); may not recognize danger.	Can be impaired by exhaustion, poor planning, or accident.	Severely impaired judgment, leading to disregard for cold and inability to seek shelter.
Underlying Health	Fewer preexisting conditions, but dehydration and illness increase risk.	High prevalence of chronic illnesses like cardiovascular disease, hypothyroidism, and diabetes.	General health typically good, but exertion and fatigue are factors.	Poor general health, malnutrition, and other related conditions common.
Environmental Risks	Cold bedrooms, inadequate clothing.	Inadequate indoor heating, poorly insulated homes.	Weather conditions (wetness, wind, cold), accidents (falling into water).	Outdoor exposure, lack of shelter, being unconscious in a cold environment.

Prevention and recognizing the signs

Prevention is always the best strategy. For vulnerable groups like the elderly, it's important to keep homes heated to at least 68°F and ensure they have proper clothing. For outdoor activities, wearing layered, moisture-wicking clothing is key. For a comprehensive guide on staying safe in winter weather, consult the resources provided by the CDC on preventing hypothermia.

If you suspect someone has hypothermia, look for signs such as shivering, exhaustion, confusion, memory loss, and slurred speech. In infants, symptoms include bright red, cold skin and very low energy. Always seek immediate medical attention if you suspect a serious case.

Conclusion

Hypothermia is a serious health risk that affects more than just those in extreme cold. By understanding the diverse range of risk factors—from age and underlying medical conditions to substance abuse and inadequate heating—we can better protect the most vulnerable members of our communities. Vigilance and proper precautions are essential for preventing this dangerous condition.

Frequently Asked Questions

Yes, it is possible to develop hypothermia indoors, especially for older adults or infants in a poorly heated home or one with an improperly set thermostat. Even temperatures between 60 and 65°F can be risky for the elderly.

Contrary to myth, alcohol actually increases the risk of hypothermia. While it may create a feeling of warmth, it causes blood vessels to expand, leading to faster heat loss from the skin. It also impairs judgment and the body's ability to shiver.

Several medical conditions can increase your risk, including an underactive thyroid (hypothyroidism), diabetes, heart disease, poor circulation, and neurological disorders like Parkinson's disease. These can interfere with the body's temperature regulation.

Infants lose heat faster than adults because they have a larger body surface area relative to their weight and less insulating body fat. They also can't shiver effectively to generate heat and are less able to communicate if they are cold.

Anyone spending a long period outdoors, such as hikers, hunters, or campers, is at risk. This risk is magnified by getting wet from rain, sweat, or falling into water, which drastically increases heat loss.

Yes, some medications can increase your vulnerability to hypothermia. These include certain antidepressants, antipsychotics, narcotic pain medicines, and sedatives, which can affect the body's ability to regulate its temperature.

A person with dementia or a mental health condition may have impaired judgment and not dress properly for cold weather. They may also wander away from home and get lost, increasing their exposure to cold or wet conditions.