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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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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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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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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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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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Frailty, a measure of biological aging, impacts chronic pain management more than chronological age. Assessing frailty can improve pain care and prevent undertreatment in older adults.

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Area of Science:

  • Gerontology
  • Pain Management
  • Clinical Medicine

Background:

  • Chronic pain is a widespread and debilitating condition, particularly challenging in older and frail individuals.
  • Chronological age is often used in clinical decision-making, but frailty offers a more accurate biological assessment.

Purpose of the Study:

  • To investigate the independent associations of chronological age, frailty, and sex with pain management variables.
  • To analyze pain management in a community-based adult population.

Main Methods:

  • A cross-sectional study of 455 adults with chronic non-cancer pain.
  • Frailty assessed using a 31-item frailty index (FI) based on deficit accumulation.
  • Multivariable regression models analyzed associations between age, FI, sex, and pain outcomes.

Main Results:

  • Frailty independently predicted increased NSAID self-medication, greater use of nonpharmacological interventions, and consumption of multiple analgesic classes.
  • Older age was linked to reduced NSAID/anxiolytic prescriptions and less physiotherapy use.
  • Frailty and age demonstrated opposing associations with prescribed analgesic numbers and healthcare utilization.

Conclusions:

  • Frailty, as a proxy for biological age, showed stronger associations with pain management patterns than chronological age.
  • Relying solely on age may result in undertreatment and ageist biases in pain care.
  • Incorporating frailty assessment into pain management strategies can lead to more personalized and effective care.