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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

161
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...
161
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

179
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...
179
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

135
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...
135
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

127
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...
127
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

135
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...
135
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

158
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...
158

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Updated: Dec 21, 2025

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Extending Screening in "Elderly" Patients: Should We Consider a Selective Approach?

Eugenia C Ip1, Ruben B Cohen-Hallaleh2, Alexander K Ng3

  • 1Department of Surgery, Bankstown-Lidcombe Hospital, Sydney, Australia.

Clinical Breast Cancer
|May 14, 2020
PubMed
Summary

Breast cancer screening for women over 70 identifies cancers at earlier stages, leading to significantly improved survival rates. Extending screening eligibility may benefit older women, improving breast cancer outcomes.

Keywords:
Breast cancerElderlyScreeningSurvivalTreatment

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Area of Science:

  • Oncology
  • Public Health
  • Geriatric Medicine

Background:

  • Breast cancer screening reduces mortality but is limited to ages 45-69 in New Zealand.
  • Older women (over 70) face increased breast cancer risk, yet are excluded from current screening programs.
  • This study investigates outcomes for women over 70 diagnosed with breast cancer through screening versus clinical detection.

Purpose of the Study:

  • To compare the characteristics and survival outcomes of screen-detected versus clinically detected breast cancers in women aged 70 years and over.
  • To evaluate the effectiveness of mammography screening in an older population.
  • To inform potential policy changes regarding breast cancer screening eligibility.

Main Methods:

  • Retrospective review of prospectively collected data from the Auckland Breast Cancer Register (June 2000 - May 2013).
  • Comparison of demographic and tumor characteristics between screen-detected and clinically detected invasive breast cancer and ductal carcinoma in situ in women aged 70+.
  • Analysis of 5-year disease-free and overall survival rates.

Main Results:

  • 2128 women aged 70+ diagnosed with breast cancer; 19.5% were screen-detected.
  • Screen-detected cancers were more common in the 70-74 age group and presented at lower T and N stages.
  • Five-year disease-specific survival (93.7% vs. 81.9%) and overall survival (84.7% vs. 57.4%) were significantly better for screen-detected cancers.

Conclusions:

  • Mammography screening identifies breast cancer in women aged 70 and over at earlier stages, correlating with improved survival.
  • Despite potential biases, extending screening eligibility to age 74 warrants consideration after assessing individual health status.
  • Early detection through screening offers significant survival benefits for older women with breast cancer.