Physical, Psychological, and Behavioral Impacts of Heatwaves on Older Adults in Rural Spain from the Perspective of Environmental Gerontology: An Integrative Analytical Framework of Vulnerability.

Extreme heat events disproportionately affect older adults in rural areas, where structural vulnerabilities remain unexplored. This study explores the physical, psychological, and behavioral impacts of heatwaves, and environmental and material conditions, which determine the vulnerability of older adults in rural Spain, using the interdisciplinary approach of environmental gerontology. The qualitative methodology analyzes 40 in-depth interviews with older adults from provinces with high heat-related mortality (Zamora, Cáceres, Ourense, Madrid). The results reveal that extreme heat is perceived as a persistent threat with physical (chronic fatigue, exacerbation of comorbidities), psychological (anxiety), and behavioral (restructuring of routines, social isolation) impacts, aggravated by inadequate housing and scarce resources. The findings contribute to conceptualizing thermal frailty as the vulnerability derived from physiological deterioration, emotional stress, and environmental constraints. The integrative analytical framework VRA-EH (Vulnerability of Rural Aging to Extreme Heat) is presented, which contributes to multidimensional and multiscale understanding of heat vulnerability in rural older adults, highlighting their capacity for action, based on adaptive behaviors and traditional knowledge, despite growing limitations. The research provides an empirical basis to guide applied research, and the design of public policies and interventions tailored to each territory, combining environmental justice, community resilience, and even climate adaptation for older people.