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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...

Cancer Survival Analysis

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Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...

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...

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 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 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...

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Alterations in comprehensive geriatric assessment decrease survival of elderly patients with cancer.

M Frasca¹, P Soubeyran², C Bellera³

¹Bordeaux Population Health Research Center, Epicene team, UMR 1219, Inserm, Univ. Bordeaux, F-33000, Bordeaux, France; Department of Palliative Medicine, Bordeaux University Hospital, F-33000, Bordeaux, France.

European Journal of Cancer (Oxford, England : 1990)

|December 22, 2017

Summary

This summary is machine-generated.

Comprehensive geriatric assessment (CGA) domains significantly impact survival in elderly cancer patients. Altered health domains increase mortality risk, with effects varying by subgroup and time, highlighting the importance of CGA in oncology.

Keywords:

Cancer Comprehensive geriatric assessment Directed acyclic graph Frail elderly Survival

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Quantifying Cognitive Decrements Caused by Cranial Radiotherapy

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Published on: October 18, 2011

Area of Science:

Geriatric oncology
Clinical assessment
Survival analysis

Background:

Comprehensive geriatric assessment (CGA) is recommended for elderly cancer patients.
The impact of specific CGA domains on mortality risk requires clarification.

Purpose of the Study:

To determine the independent association between each CGA domain and overall survival (OS) in elderly cancer patients.

Main Methods:

Analysis of the ONCODAGE cohort (1264 patients).
Utilized Cox models to estimate hazard ratios for each CGA domain.
Directed Acyclic Graphs (DAGs) were used for covariate selection.

Main Results:

Each altered CGA domain was associated with a higher risk of death.
Effects varied by gender, age, education, and time from inclusion.
Nutritional status, mobility, autonomy, neurological, and psychological domains showed significant associations with mortality.

Conclusions:

Altered CGA domains independently increase mortality risk in elderly cancer patients.
The influence of specific domain alterations can be subgroup- and time-dependent.