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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...

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 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...

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 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...

The Effect of Aging on Tissues

The Effect of Aging on Tissues

Several body functions deteriorate with age. The external signs of aging are easily identifiable. For example, the skin becomes dry, less elastic, and thins out, forming wrinkles. The skin of the face begins to appear looser due to a decrease in the levels of elastic and collagen fibers in the connective tissue. Additionally, melanin production in the hair follicle decreases with age, resulting in gray hair. Moreover, the senses of sight and hearing decline, so glasses and hearing aids may...

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Glycemic Impact on Knee Osteoarthritis Symptoms on Physical, Radiographic, and Inflammatory Markers among Individuals Aged 50 and Over with Diabetes

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Total knee arthroplasty in the elderly: does age affect pain, function or complications?

Ian W Kennedy¹, Linda Johnston, Lynda Cochrane

¹The Western Infirmary, Glasgow, G11 6NT, UK. jkennedy6@nhs.net

Clinical Orthopaedics and Related Research

|January 29, 2013

Summary

Octogenarians undergoing total knee arthroplasty (TKA) experience similar pain relief and Knee Society Scores (KSS) compared to younger patients. However, they report lower function (KSFS) and higher complication rates post-surgery.

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Published on: March 24, 2023

Area of Science:

Orthopedic Surgery
Geriatric Medicine
Clinical Outcomes Research

Background:

Total knee arthroplasty (TKA) is a common procedure in the elderly.
Limited data exists on how age impacts TKA outcomes, specifically pain, function, and complications.
Previous studies often lack sufficient follow-up, adequate sample sizes, or comparator groups.

Purpose of the Study:

To investigate if advanced age (80 years and older) negatively affects postoperative pain, Knee Society Scores (KSS), and complication rates after TKA.
To compare outcomes of TKA in octogenarians versus patients younger than 80.

Main Methods:

Retrospective review of 438 patients aged 80+ undergoing primary TKA (1995-2005).
Established a comparator group of 2754 patients younger than 80.
Assessed pain, KSS, Knee Society Function Score (KSFS), and complication rates (Dindo et al. classification grade ≥2) with a minimum 5-year follow-up.

Main Results:

No significant differences in pain scores at 3, 5, and 10 years between octogenarians and the younger group.
Knee Society Scores (KSS) were comparable at 5 years.
Knee Society Function Scores (KSFS) were lower in octogenarians.
Major complication rates were higher in the octogenarian group (19% vs. 15%).

Conclusions:

Octogenarians undergoing TKA achieve comparable pain relief and KSS to younger patients.
Functional outcomes (KSFS) are reduced in octogenarian TKA patients.
The rate of major complications is elevated in octogenarians following TKA.