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

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

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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 Metabolism01:18

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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...
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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
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Headache in the elderly.

Robert G Kaniecki1, Andrew D Levin1

  • 1Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, United States.

Handbook of Clinical Neurology
|November 23, 2019
PubMed
Summary
This summary is machine-generated.

Headaches are common in the elderly, with primary causes like migraine being frequent. However, older adults are more prone to serious secondary headache causes, requiring careful evaluation.

Keywords:
ElderlyFacial painHeadacheMigraine

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Area of Science:

  • Neurology
  • Geriatrics

Background:

  • Headache is a prevalent neurologic symptom affecting half the global population.
  • While decreasing with age, headaches remain common in elderly individuals.
  • Headaches are classified as primary (e.g., migraine, tension-type) or secondary (due to underlying causes).

Purpose of the Study:

  • To review the characteristics and management of headaches in the elderly population.
  • To highlight the increased risk of secondary causes in older adults with new-onset headaches.
  • To discuss diagnostic approaches and challenges in managing headaches in geriatric patients.

Main Methods:

  • Review of existing literature on headaches in the elderly.
  • Analysis of primary versus secondary headache prevalence in older populations.
  • Discussion of diagnostic tools (Head CT, MRI) and red flag symptoms.
  • Consideration of management challenges including comorbidities and polypharmacy.

Main Results:

  • Primary headaches account for approximately two-thirds of headaches in the elderly.
  • Older adults with new-onset headaches have a significantly higher likelihood (12x) of serious underlying secondary causes.
  • Diagnostic imaging (CT for acute, MRI for chronic) is crucial when red flags are present.

Conclusions:

  • Headaches in the elderly necessitate a high index of suspicion for secondary causes.
  • Effective management requires careful consideration of comorbidities, polypharmacy, and altered drug metabolism.
  • Prompt and appropriate diagnostic evaluation is essential for optimizing outcomes in geriatric headache patients.