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Drug Dosing: Geriatric Patients

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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...

Pharmacodynamics in Geriatric Patients: Effects of Age

Pharmacodynamics in Geriatric Patients: Effects of Age

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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...

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...

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Updated: Jul 7, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Emergency department utilization patterns among older adults.

Fredric D Wolinsky¹, Li Liu, Thomas R Miller

¹The Iowa City VA Medical Center, Iowa, USA. fredric-wolinsky@uiowa.edu

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences

|March 4, 2008

Summary

Nearly half of older adults visited the emergency department (ED) over four years. Most ED visits were for high-intensity care, suggesting few were avoidable and triaging Medicare patients may not reduce overcrowding.

Related Experiment Videos

Last Updated: Jul 7, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Area of Science:

Gerontology
Health Services Research
Public Health

Background:

Understanding emergency department (ED) utilization patterns in older adults is crucial for healthcare planning.
Previous research has not fully elucidated the factors associated with different types of ED use among this demographic.

Purpose of the Study:

To identify 4-year ED use patterns in adults aged 70 and older.
To determine the sociodemographic and health-related factors associated with low-intensity, high-intensity, and mixed ED use patterns.

Main Methods:

Secondary analysis of the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD) linked to Medicare claims.
Utilized Current Procedural Terminology (CPT) codes to define low-intensity (99281-99282) and high-intensity (99283-99285) ED visits.
Employed exploratory factor analysis and multivariable multinomial logistic regression.

Main Results:

56.6% of participants had no ED visits in the 4-year period.
28.9% exclusively used the ED for high-intensity visits, while 5.7% used it only for low-intensity visits, and 8.7% had mixed use.
Factors associated with specific ED use patterns included cognitive function (word recall), geographic location (metropolitan vs. rural), age, morbidity, functional status, and education level.

Conclusions:

Nearly half of older adults accessed ED services at least once over four years.
A small proportion of ED visits were exclusively for low-intensity care, suggesting limited potential for avoidance.
Findings suggest that triaging Medicare patients is unlikely to significantly alleviate ED overcrowding, though ongoing monitoring of ED use is warranted.