Pharmacotherapy in the extreme longevity

The increased longevity brings to the appearance of more polypathologies, being frequently of chronic-degenerative type, and also an increased use of pharmaca. The present study evaluated the usual drug consumption in the ultralongevous people in comparison with their clinical conditions. A total of 602 centenarians were involved: clinical anamnesis, objective examinations and clinico-functional evaluations were performed. In 555 of them an acceptable pharmacological anamnesis was obtained. The results showed that 28 centenarians (5%) did not take any drug, 527 (95%) of them used regularly some pharmacological therapy. Their distribution was: 1 drug/day 68 (13%), 2 drugs/day 86 (16.3%), 3 drugs/day 344 (65.2%), more than 3 drugs/day 29 (5.5%). The mean daily drug consumption was 2.7+/-1.4. Good clinical conditions could be established in 115 (20.7%) of the centenarians, of them 28 subjects (24.3%) had used no drugs, 87 (75.7%) of them used 1-3 drugs/day. It was an important observation that adverse drug events (ADE) occurred in 15.2%. The ADE occurs frequently also in polypharmacological treatments, with various pharmacodynamic and pharmaco-kinetic modifications of the drugs. The mean daily drug consumption of the ultralongevous subjects was lower than that of the common elderly. This may be due to the past life of our centenarians, characterized by satisfactory health conditions, and also to a higher attention of the general practitioners in the drug prescriptions, as well as of the family members who administer the pharmaca.