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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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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

Pharmacodynamics in Geriatric Patients: Effects of Age

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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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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...
400
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

354
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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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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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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

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Published on: January 11, 2020

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[Do not screen all elderly for cognitive impairment].

Mattijs E Numans1, Annet W Wind

  • 1Leids Universitair Medisch Centrum, afd. Public Health en Eerstelijns Geneeskunde, Leiden.

Nederlands Tijdschrift Voor Geneeskunde
|April 3, 2014
PubMed
Summary
This summary is machine-generated.

Routine screening for cognitive impairment in older adults lacks evidence. While the Mini-Mental State Examination (MMSE) can diagnose dementia, interventions for screened individuals show no proven benefits.

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Area of Science:

  • Gerontology
  • Neurology
  • Primary Care Medicine

Background:

  • Early and routine screening for cognitive impairment in older adults is advocated to enable proactive interventions and improve treatment outcomes.
  • However, robust scientific evidence supporting the efficacy of this screening strategy is currently lacking.
  • The Mini-Mental State Examination (MMSE) is a widely used tool for assessing cognitive function.

Purpose of the Study:

  • To evaluate the scientific evidence supporting early and routine screening for cognitive impairment in older individuals.
  • To assess the effectiveness of interventions for individuals identified through cognitive screening.
  • To determine the appropriate role of the MMSE in primary care settings for older patients.

Main Methods:

  • A systematic review of screening instruments for cognitive impairment was conducted.
  • The review analyzed interventions, both pharmacological and non-pharmacological, applied to individuals identified through screening.
  • Evidence for the effectiveness of the Mini-Mental State Examination (MMSE) in diagnosing dementia and mild cognitive impairment was assessed.

Main Results:

  • The Mini-Mental State Examination (MMSE) is adequate for confirming dementia and, to a lesser extent, mild cognitive impairment.
  • No pharmacological interventions demonstrated convincing positive effects in individuals identified via screening.
  • Non-pharmacological, caregiver-oriented interventions also lacked convincing evidence of efficacy for screened populations.

Conclusions:

  • The MMSE is suitable for diagnosing dementia in primary care settings.
  • Routine screening of cognitively healthy older patients using the MMSE is not supported by current evidence.
  • Further research is needed to establish effective interventions for individuals with cognitive impairment identified through screening.