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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

339
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...
339
Drug Dosing: Obese Patients01:21

Drug Dosing: Obese Patients

321
In the United States, obesity is a prominent concern. It is linked to heightened mortality rates due to increased occurrences of conditions such as hypertension, atherosclerosis, coronary artery disease, and diabetes compared to nonobese individuals. A patient is classified as obese if their actual body weight surpasses the ideal or desirable body weight by 20%, based on Metropolitan Life Insurance Company data. Ideal body weights consider average weights and heights for males and females...
321
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

298
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...
298
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution01:25

Pharmacokinetics in Obese Patients: Drug Absorption and Distribution

336
Obesity significantly alters the pharmacokinetic processes of drug absorption and distribution, presenting unique challenges in medical treatment. The increased fat tissue and decreased lean muscle in obese individuals can significantly affect how drugs are absorbed into the body and distributed across different tissues. This alteration can lead to variances in the effectiveness and safety of medications, necessitating adjustments in dosing or drug selection for obese patients.One notable...
336
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

300
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...
300
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

307
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...
307

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Sleeve Gastrectomy in Mice using Surgical Clips
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Is bariatric surgery safe in the elderly population?

Federico Perez Quirante1, Lisandro Montorfano1, Rajmohan Rammohan1

  • 1The Bariatric and Metabolic Institute, Section of Minimally Invasive and Endoscopic Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33321, USA.

Surgical Endoscopy
|January 1, 2017
PubMed
Summary

Bariatric surgery is effective for morbid obesity in older adults. Elderly patients (>65) had comparable complication rates to younger patients, with a lower readmission rate, indicating safety and efficacy in this demographic.

Keywords:
Bariatric SurgeryComplicationsElderlyGastric bypassLaparoscopic sleeve gastrectomy

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Area of Science:

  • Surgical outcomes
  • Geriatric medicine
  • Obesity treatment

Background:

  • Bariatric surgery is the most effective treatment for morbid obesity across all age groups.
  • Medical treatment is considered inferior to surgical intervention for obesity management.
  • The study focuses on the outcomes of bariatric surgery in patients aged 65 years and older.

Purpose of the Study:

  • To report the outcomes of bariatric surgery in patients over 65 years of age.
  • To compare the outcomes of bariatric surgery in elderly patients versus younger patients.
  • To assess the safety and efficacy of bariatric procedures in an older population.

Main Methods:

  • Retrospective review of a prospectively collected database.
  • Comparison of patients over 65 years (Group B) with patients under 65 years (Group A).
  • Analysis of preoperative BMI, postoperative complications, comorbidities, and length of stay.

Main Results:

  • Elderly patients (Group B) had a higher proportion of males and more comorbidities (hypertension, sleep apnea, hypercholesterolemia).
  • Despite longer length of stay, elderly patients had a lower readmission rate.
  • Complication rates were comparable between groups, with a higher incidence of de novo GERD in the elderly.

Conclusions:

  • Age is not a significant risk factor for surgical complications following bariatric surgery.
  • Elderly patients, despite having more comorbidities, experience comparable surgical complication rates to younger patients.
  • Bariatric surgery is a safe and effective treatment option for morbid obesity in patients over 65 years of age.