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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 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...

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 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...

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Updated: May 14, 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

[Review in geriatric medicine 2012].

K Major¹, L Saiah, E Rubli

¹Service de gériatrie et réadaptation gériatrique, Département de médecine, CUTR Sylvana, CHUV, 1066 Epalinges.

Revue Medicale Suisse

|February 2, 2013

Summary

Regular exercise benefits older adults by compressing morbidity. For older diabetics, especially with cognitive issues, HbA1c targets of 8-9% may be appropriate, while Alzheimer's changes begin decades before symptoms.

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Last Updated: May 14, 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 and Geriatric Medicine
Neurology
Endocrinology

Background:

Evidence suggests exercise compresses morbidity in active older individuals.
Therapeutic targets for older diabetics, particularly those with cognitive impairment or dementia, warrant revision.
Alzheimer's disease may exhibit biological and structural abnormalities 25 years prior to clinical onset.

Purpose of the Study:

To summarize recent findings on exercise benefits in the elderly.
To discuss revised therapeutic targets for elderly diabetics with cognitive impairment.
To review advancements in Alzheimer's disease research and dementia treatment.

Main Methods:

Review of 2012 evidence on exercise and morbidity compression.
Analysis of studies on glycemic control in older diabetics with cognitive impairment.
Examination of research on early Alzheimer's disease markers.
Evaluation of randomized controlled trials (RCTs) for dementia therapeutics.

Main Results:

Active older persons demonstrated morbidity compression.
An HbA1c target of 8-9% is suggested as a compromise for older diabetics with cognitive impairment or dementia.
Alzheimer's-related abnormalities may precede clinical manifestation by 25 years.
Ginkgo and combination therapy (memantine/donepezil) failed in RCTs; treatment interruption for behavioral symptoms of dementia could be detrimental.

Conclusions:

Exercise remains crucial for healthy aging and morbidity compression.
Personalized glycemic targets are essential for elderly diabetics with cognitive decline.
Early detection of Alzheimer's disease is critical for future interventions.
Current therapeutic strategies for dementia require further investigation, and treatment interruption should be approached cautiously.