Mark Loehrke Times correspondent

From crisp, clear nighttime skies to gently falling snowflakes, a Midwest winter can create moments of beauty and awe. But that tends to bring with it a number of seasonal hazards, many of which tend to disproportionately affect older adults.

Drawing from her dual perspective as a board-certified family medicine physician with Franciscan Alliance in St. John and the daughter of aging parents, Dr. Dana Elsherif has seen how winter can pose unique challenges for seniors. And she has some well-informed advice on how older adults can prepare themselves for several of the biggest wintertime hazards.

Falls

Falls represent one of the top reasons for emergency-room visits among the elderly. And though ice and snow often get the blame, Elsherif says the causes are usually hidden beneath the surface.

For instance, some seniors may stumble due to underlying health conditions, such as a history of strokes, dementia or Parkinson's, while others might be struggling with something as simple as dehydration or low vitamin levels, such as a B12 or iron deficiency.

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"When I discover that a patient has low iron levels I always investigate further, as this could signal more serious conditions such as ulcers, colon cancer or inflammatory bowel diseases," Elsherif says. "It's crucial to address these underlying issues, rather than simply treating the fall risk itself."

One other thing to consider when it comes to fall risk: The medicine cabinet. Elsherif says common drugs such as antihistamines including Benadryl, anti-anxiety medications such as Xanax or Ativan, sleeping pills such as Ambien and even certain antidepressants can affect balance more than one might expect.

Water pills (diuretics) also demand special attention, as they can lead to dehydration and dizziness if not monitored properly.

Elsherif recommends implementing safety measures at home to prevent falls, and perhaps using a cane or a walker when needed. And just like everyone else this time of year, be sure to keep an eye out for ice.

Frostbite

Frostbite tends to target exposed skin areas, such as fingers, toes, ears, noses and cheeks. Early warning signs include feeling cold, followed by numbness and tingling in the affected areas -- symptoms that tend to come on quickly. Severe frostbite can require hospital treatment and possibly lead to amputation.

Elsherif notes that while rewarming affected areas in warm water can help relieve frostbite, this should be done only if there's no risk of the area refreezing, which can cause more damage. Also, while ibuprofen can help limit tissue damage and reduce pain and inflammation, it should be taken only under medical supervision, as some patients may have conditions that make NSAIDs unsafe.

Hypothermia

Seniors who have difficulty caring for themselves or who have medical conditions that can affect their circulation are more vulnerable to hypothermia. Also, conditions that affect circulation, such as heart failure, diabetes or thyroid problems, can make it harder for the body to maintain its temperature. Elsherif notes that seniors and their caregivers should watch for subtle signs of hypothermia, such as shivering, slurred speech, confusion or unusual fatigue.

The key to prevention, she says, is layering clothing smartly -- think wool or fleece for insulation, with breathable outer layers to manage moisture. It's also vitally important to keep the feet warm with adequate socks.

Dry skin

The exceedingly dry air of winter doesn't just cause discomfort; it also can lead to serious skin complications in seniors. Dry skin can eventually crack, which is an open invitation for infections. Dry skin can can cause conditions such as eczema to flare up.

"A daily moisturizing routine, particularly after bathing, can make all the difference," Elsherif advises. "Consider also using a humidifier to combat the drying effects of indoor heating."

Dehydration

Most people don't realize that winter dehydration is just as concerning as summer thirst. Elsherif says to keep an eye out for dark urine or unusual dizziness and, in severe cases, confusion -- all of which can be signs of dangerous dehydration.

And while hot tea and soup can help maintain hydration and warmth, she cautions that alcohol and caffeine can work against hydration goals.

Winter bugs

When it comes to common colds, antibiotics are not always the answer. Elsherif notes that most winter sniffles tend to resolve within a week with simple supportive care. But if symptoms persist beyond seven days and include moderate to severe pain or high fever, it's probably time to seek medical attention. Prevention, including staying up-to-date with vaccinations, remains the best strategy for warding off serious winter illnesses.

"I recommend appropriate vaccinations, including the flu shot, pneumonia vaccine, COVID-19 vaccine and RSV vaccine when indicated," Elsherif says. "In addition to regular hand-washing, these can provide crucial protection during the winter months."

Winter blues

Winter's shorter, darker days can take a toll on mental health -- especially during the holiday season -- and social isolation often compounds these feelings.

Elsherif encourages her patients to maintain regular contact with friends and family, through visits, calls or video chats.

"Ultimately, staying healthy through winter is not only about avoiding illness, it's about maintaining quality of life," she notes. "Don't hesitate to reach out to your health-care providers with concerns. We're here to help you or your loved ones navigate this challenging season safely."

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