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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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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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Dose-Response Relationship: Potency and Efficacy01:22

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The potency of a drug is the measure of its ability to produce a biological response and can be compared by looking at the half-maximum effective concentration or EC50 values of different drugs. A lower EC50 value indicates higher potency of the drug. In the dose–response curve of two antihypertensive drugs, candesartan and irbesartan, a significant difference is observed in their EC50 values. A lower EC50 value for candesartan indicates that it is more potent than irbesartan, as it...
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Agonists can bind with and activate receptors, resulting in the formation of drug-receptor complexes. Once formed, these complexes catalyze many biochemical processes at the cellular level and subsequently induce a pharmacologic response. The degree of response is directly proportional to the fraction of activated receptors, which in turn, depends on the concentration of the drug at the receptor site as well as the sensitivity of the receptor. An increase in the administered dose contributes to...
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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

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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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Dose-response walking activity and physical function in older adults.

Christopher J Dondzila1, Keith P Gennuso, Ann M Swartz

  • 1Department of Health, Exercise, and Sport Science, The Citadel, Charleston, SC.

Journal of Aging and Physical Activity
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Summary

Increased walking activity significantly improves physical function in older adults. Higher daily step counts correlate with better self-reported health and mobility, highlighting the importance of physical activity for aging well.

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Area of Science:

  • Gerontology
  • Exercise Science
  • Public Health

Background:

  • Physical function declines with age, impacting independence and quality of life in community-dwelling older adults.
  • Understanding the relationship between physical activity and physical function is crucial for promoting healthy aging.

Purpose of the Study:

  • To investigate the dose-response relationship between daily walking activity and physical function in older adults.
  • To determine if higher levels of physical activity are associated with better physical function outcomes.

Main Methods:

  • 836 community-dwelling older adults participated.
  • Physical activity was measured using pedometry (steps/day) and categorized into four groups.
  • Physical function was assessed using the SF-36 self-report questionnaire and the 6-minute walk test (6MWT).

Main Results:

  • A positive dose-response relationship was observed between physical activity levels and both SF-36 and 6MWT scores.
  • Higher daily step counts (≥ 7,501 steps/day) were associated with significantly higher physical function scores compared to lower activity groups.
  • Physical activity levels were strong predictors (p < .0001) of physical function.

Conclusions:

  • Increasing walking activity demonstrates a clear dose-response effect on physical function in older adults.
  • Low levels of physical activity are a significant indicator of poorer physical function in this population.
  • Promoting regular walking is essential for maintaining and improving physical function in community-dwelling older adults.