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Aging01:26

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Aging is a complex biological phenomenon influenced by various processes that affect cellular and systemic functions. Several prominent theories attempt to explain its mechanisms, highlighting cellular limitations, oxidative damage, and hormonal changes as central factors in aging.
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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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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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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

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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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Several body functions deteriorate with age. The external signs of aging are easily identifiable. For example, the skin becomes dry, less elastic, and thins out, forming wrinkles. The skin of the face begins to appear looser due to a decrease in the levels of elastic and collagen fibers in the connective tissue. Additionally, melanin production in the hair follicle decreases with age, resulting in gray hair. Moreover, the senses of sight and hearing decline, so glasses and hearing aids may...
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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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Prefrailty in older adults: A concept analysis.

Jananee Rasiah1, Greta G Cummings1, Andrea Gruneir2

  • 1Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), 11405 87 Avenue, Edmonton, AB Canada T6G 1C9.

International Journal of Nursing Studies
|May 26, 2020
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Summary

Prefrailty is a clinically silent process that increases the risk of frailty in older adults. Understanding its attributes and antecedents is crucial for early identification and intervention in geriatric care.

Keywords:
concept analysisfrailtygeriatric medicinenursingolder adultsprefrailty

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Area of Science:

  • Gerontology
  • Clinical Nursing
  • Public Health

Background:

  • The concept of prefrailty lacks clear definition and theoretical evidence, often being discussed only in relation to frailty.
  • Existing research on frailty lacks consensus on measurement, further complicating the understanding of prefrailty.

Purpose of the Study:

  • To conduct a concept analysis of prefrailty to enhance understanding of this phenomenon in older adults.
  • To clarify the distinct characteristics, origins, and outcomes of prefrailty.

Main Methods:

  • Employed Rodgers and Knafl's evolutionary concept analysis approach.
  • Conducted a comprehensive literature search across MEDLINE, CINAHL, and Abstracts in Social Gerontology databases.
  • Utilized thematic analysis to identify attributes, antecedents, and consequences of prefrailty from 41 included articles.

Main Results:

  • Prefrailty is characterized by predisposing, non-specific, multidimensional, and cumulative attributes.
  • Antecedents include sociodemographic factors, comorbidity, behaviors, and clinical markers.
  • Consequences involve an increased risk of adverse outcomes and progression to frailty, with related terms like 'increased vulnerability' and 'transitional stage'.

Conclusions:

  • Prefrailty is a clinically silent process that predisposes individuals to frailty, distinct from frailty itself.
  • The identified attributes, antecedents, and consequences aid clinicians in recognizing prefrailty in older adults.
  • Further research is recommended to build upon this concept analysis for improved clinical practice and understanding.