The clinical implications of ageing for rational drug therapy

The proportion of the elderly is constantly increasing and by the year 2025 20% of the population will be above 65 years of age. With advanced age, subjects will develop multiple diseases and often need to take several drugs.

This polypharmacy increases the risk for drug interactions and adverse effects. In addition, age-related physiological changes affect different biological systems and can contribute to alterations in pharmacokinetics and pharmacodynamics in older patients, which are more often seen in the frail than in the fit elderly. These features will complicate drug therapy in the elderly, and a careful dose titration is advisable. Furthermore, inappropriate drug prescription and non-adherence to medication represent common therapeutic challenges in elderly subjects. To date, there is no evidence of any effective antiageing agent.

This review summarizes present knowledge of age-related problems in drug action and their clinical implications for an increasingly important population.