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Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Cognitive Development During Adulthood

Cognitive development continues throughout adulthood, undergoing significant shifts across early, middle, and late stages. Individual transition occurs from adolescent idealism to pragmatic and adaptable thinking in early adulthood. During this period, individuals learn to integrate personal beliefs with the recognition that other perspectives are equally valid. Exposure to the complexities of modern society, diverse experiences, and higher education contribute to this adaptive thought process,...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are not...
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Semi-Targeted Ultra-High-Performance Chromatography Coupled to Mass Spectrometry Analysis of Phenolic Metabolites in Plasma of Elderly Adults
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Plasma selenium over time and cognitive decline in the elderly.

Tasnime N Akbaraly1, N Tasnime Akbaraly, Isabelle Hininger-Favier

  • 1Inserm E361 Université Montpellier1, Montpellier, France. akbaraly@montp.inserm.fr

Epidemiology (Cambridge, Mass.)
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Declining selenium levels over time are linked to cognitive decline in older adults. Maintaining adequate selenium status may be crucial for preserving brain health and neuropsychological function in aging populations.

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Area of Science:

  • Gerontology
  • Nutritional Neuroscience
  • Oxidative Stress Research

Background:

  • Brain oxidative stress is a known contributor to cognitive impairment.
  • Selenium, an essential antioxidant, is investigated for its potential neuroprotective effects.
  • Age-related decline in selenium levels may impact cognitive function.

Purpose of the Study:

  • To investigate the association between longitudinal changes in selenium levels and cognitive decline.
  • To examine the relationship in a cohort of community-dwelling elderly French individuals.

Main Methods:

  • A 9-year longitudinal study involving 1389 participants (aged 60-71).
  • Six waves of follow-up included neuropsychological testing for cognitive function evaluation.
  • Mixed linear and logistic models were used to analyze the association between selenium change and cognitive decline, accounting for within-subject correlations.

Main Results:

  • Decreases in plasma selenium over time were significantly associated with cognitive decline, after adjusting for confounders.
  • A greater decrease in plasma selenium correlated with a higher probability of cognitive decline.
  • Even the smallest increases in selenium were associated with greater cognitive decline, suggesting a complex relationship.
  • No significant association was found between short-term (2-year) selenium changes and cognitive changes.

Conclusions:

  • Selenium status naturally decreases with advancing age.
  • Age-related decreases in selenium may play a role in the decline of neuropsychological functions.
  • These findings highlight the importance of selenium status in maintaining cognitive health during aging.