[Pharmacologic therapy in the elderly]

The pharmacological treatment in the older people should be carefully considered: older patients are at the same time the greatest consumers of drugs and the population with the greatest risk of adverse drug reactions (ADR). The ADR are in the old patient more frequent and serious for the greater number of concurrent drugs. The incorrect drug's use consists in prescribing too much or too little, for an excessive period, without a defined diagnosis and an appropriate selection of the better compound. Moreover, beneficial drugs may be frequent underused, some chronic conditions do not receive adequate pharmacologic treatment, and an ADR may be misinterpreted as a new pathological condition that requires a new prescription. The unusual presentation of many diseases in elderly play a role to complicate the clinical process necessary to optimising the drug treatment. About the risks and the benefits of pharmacological treatment, adequate data in older patients are in general lacking for the poor inclusion in clinical trials of the elderly subjects, especially frail persons.