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Related Concept Videos

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...
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

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 Age01:27

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 Absorption01:22

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 Distribution01:00

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 Metabolism01:18

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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When is it the right time to ask for a geriatrician?

Audrey K Chun1

  • 1Mount Sinai School of Medicine, New York, NY, USA. audrey.chun@mssm.edu

The Mount Sinai Journal of Medicine, New York
|July 13, 2011
PubMed
Summary

Geriatric expertise is crucial for older adults. It benefits patients aged 85+, those with complex conditions, frailty, disability, dementia, or needing end-of-life care.

Area of Science:

  • Gerontology
  • Geriatric Medicine
  • Healthcare Management

Background:

  • The global population is aging rapidly.
  • There is a growing shortage of healthcare professionals specializing in geriatric care.
  • Identifying patients who most benefit from geriatric expertise is essential for efficient resource allocation.

Purpose of the Study:

  • To review the literature and identify patient characteristics that indicate a need for geriatric expertise.
  • To provide guidance for practicing physicians on the optimal timing for geriatric care consultation.

Main Methods:

  • Literature review of studies on geriatric care provision.
  • Analysis of patient factors associated with significant benefit from geriatric expertise.

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Main Results:

  • Geriatric expertise is most beneficial for patients aged 85 years and older.
  • Adults younger than 85 also benefit significantly if they have complex multimorbidity, frailty, or other geriatric conditions.
  • Patients with disability, dementia, or requiring palliative or end-of-life care are prime candidates for geriatric consultation.

Conclusions:

  • Geriatric expertise should be prioritized for the oldest adults and those with significant geriatric syndromes.
  • Physicians should consider geriatric consultation for younger adults with complex health needs and functional decline.
  • Proactive integration of geriatric care can improve outcomes for vulnerable older populations.