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Thirteen young and 17 middle\u2010aged adults (<jats:italic>n<\/jats:italic>\u00a0=\u00a030) were exposed to 2\u00a0\u00d7\u00a030\u00a0min bouts of whole\u2010body 39\u00b0C water immersion. Young adults also completed cooling mitigation strategies in a randomized cross\u2010over design. Orthostatic intolerance and selected physiological, perceptual, postural and cognitive responses were assessed. Orthostatic hypotension occurred in 94% of middle\u2010aged adults and 77% of young adults. Young adults exhibited greater dizziness upon standing (young subjects, 3 out of 10 arbitrary units (AU) vs. middle\u2010aged subjects, 2 out of 10 AU), with four terminating the protocol early owing to dizziness or discomfort. Despite middle\u2010aged adults being largely asymptomatic, both age groups had transient impairments in postural sway after immersion (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05), but no change in cognitive function (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.58). Middle\u2010aged adults reported lower thermal sensation, higher thermal comfort, and higher basic affect than young adults (all <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01). Cooling mitigation trials had 100% completion rates, with improvements in sit\u2010to\u2010stand dizziness (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01, arms in, 3 out of 10 AU vs. arms out, 2 out of 10 AU vs. fan, 4 out 10 AU), lower thermal sensation (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.04), higher thermal comfort (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.01) and higher basic affect (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.02). Middle\u2010aged adults were predominantly asymptomatic, and cooling strategies prevented severe dizziness and thermal intolerance in younger adults.<\/jats:p>","DOI":"10.1113\/ep090993","type":"journal-article","created":{"date-parts":[[2023,2,27]],"date-time":"2023-02-27T17:09:30Z","timestamp":1677517770000},"page":"554-567","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The effect of age and mitigation strategies during hot water immersion on orthostatic intolerance and thermal stress"],"prefix":"10.1113","volume":"108","author":[{"given":"Charles J.","family":"Steward","sequence":"first","affiliation":[{"name":"Centre for Sport Exercise and Life Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Campbell","family":"Menzies","sequence":"additional","affiliation":[{"name":"Centre for Sport Exercise and Life Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil D.","family":"Clarke","sequence":"additional","affiliation":[{"name":"Centre for Sport Exercise and Life Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy E.","family":"Harwood","sequence":"additional","affiliation":[{"name":"Centre for Sport Exercise and Life Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathew","family":"Hill","sequence":"additional","affiliation":[{"name":"Centre for Sport Exercise and Life Sciences Coventry University  Coventry UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5932-4793","authenticated-orcid":false,"given":"Christopher J. 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