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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

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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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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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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...
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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...
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The muscles surrounding the shoulder girdle, including the clavicle and scapula, primarily stabilize the scapula. This stable base allows other muscles to move the humerus effectively. Scapular movements often mirror those of the humerus and extend its range of motion. For instance, raising the arm above the head would not be feasible without simultaneous upward rotation of the scapula.
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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...
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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...
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Shoulder symptoms and function in geriatric patients.

Todd Burner1, Daniel Abbott, Karri Huber

  • 11Medical College of Wisconsin, Milwaukee. 2University of Wisconsin-Milwaukee.

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Severe shoulder pain is prevalent in older adults, affecting function and quality of life. Many patients do not discuss shoulder issues with providers, highlighting a gap in care for this common musculoskeletal problem.

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Area of Science:

  • Gerontology
  • Orthopedics
  • Public Health

Background:

  • Musculoskeletal problems, including shoulder pain, are a frequent reason for physician visits.
  • The impact of shoulder pain on functional level and quality of life in older adults is not well understood.
  • Older adults represent a growing demographic with unique health considerations.

Purpose of the Study:

  • To determine the prevalence of shoulder symptoms and dysfunction in older adult veterans.
  • To assess the impact of shoulder pain on functional status and quality of life in this population.
  • To identify potential risk factors and document provider-patient communication regarding shoulder issues.

Main Methods:

  • Cross-sectional survey and examination of 93 veterans aged 60+ at a VA medical center.
  • Utilized the Stanford Modified Health Assessment Questionnaire for self-assessed health and functional limitations.
  • Assessed shoulder mobility and pain through specific maneuvers; documented diabetes and statin use.

Main Results:

  • 31% of participants reported severe shoulder pain.
  • Functional limitation, measured by the Modified Health Assessment Questionnaire, correlated with reduced shoulder internal rotation (36% prevalence).
  • Few patients discussed shoulder problems with providers, and these issues were often undocumented.

Conclusions:

  • High prevalence of shoulder pain in aging populations necessitates further research into risk factors and etiologies.
  • Effective management strategies for symptomatic shoulder disease in older adults are crucial.
  • Improving documentation and patient-provider communication regarding shoulder complaints is warranted.