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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 Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

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

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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 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 Distribution01:00

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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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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
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Polypharmacy and Cognition Function Among Rural Adults.

Rafia S Rasu1,2, Nistha Shrestha3, Aliza R Karpes Matusevich1

  • 1College of Pharmacy, Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX, USA.

Journal of Alzheimer'S Disease : JAD
|May 31, 2021
PubMed
Summary

Polypharmacy, using five or more medications, significantly increases the risk of cognitive impairment in rural Texas adults. Higher medication counts correlated with poorer cognitive function, highlighting a critical public health concern.

Keywords:
Antidepressantsantidiabeticsantihypertensivecognition performancecognitive impairmentdementiamedicationspolypharmacy

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Area of Science:

  • Gerontology
  • Epidemiology
  • Pharmacology

Background:

  • Polypharmacy (≥5 medications) is linked to adverse health outcomes.
  • Previous research on chronic medication use, disease control, and cognitive function shows mixed results.
  • Further investigation is needed to understand these relationships, especially in specific populations.

Purpose of the Study:

  • To examine the association between polypharmacy and cognitive function.
  • Focus on rural-dwelling adults in Texas, USA.
  • Investigate the impact of specific chronic condition medications on cognition.

Main Methods:

  • Cross-sectional epidemiological study (Project FRONTIER) in rural Texas.
  • Included residents aged over 40.
  • Logistic regression analyzed the relationship between polypharmacy, comorbidities, and cognitive impairment.

Main Results:

  • 29.6% of 689 participants (mean age 61) had polypharmacy.
  • Polypharmacy users were 2.84 times more likely to experience cognitive impairment.
  • Hypertension medication use was associated with 1.85 times higher odds of cognitive impairment.

Conclusions:

  • Polypharmacy is associated with increased odds of cognitive impairment in this rural population.
  • Cognitive impairment risk rises with the number of medications used.
  • Urgent need for studies on medication adherence and chronic disease management in rural elders.