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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

217
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...
217
Pharmacodynamics in Geriatric Patients: Effects of Age01:27

Pharmacodynamics in Geriatric Patients: Effects of Age

182
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...
182
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption

218
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...
218
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism

192
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...
192
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

224
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...
224
Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion01:18

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion

229
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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Related Experiment Video

Updated: Jan 12, 2026

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Polypharmacy, Hyperpolypharmacy, and Associated Dementia: A Southeast Texas Nested Case-Control Study.

Jacob Thompson1, Sujin Yu2, Maryam Vasefi3

  • 1Brain and Spine Center of Southeast Texas, Beaumont, TX 77701, United States; Department of Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Science Center El Paso, El Paso, TX 79905, United States.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|October 30, 2025
PubMed
Summary

Polypharmacy, the use of multiple medications, significantly increases the risk of cognitive decline, including dementia and mild cognitive impairment. Higher numbers of medication groups correlated with greater odds of these conditions.

Keywords:
Alzheimer’s diseaseCase-controlDementiaHyperpolypharmacyMild cognitive impairmentPolypharmacy

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Area of Science:

  • Neurology
  • Gerontology
  • Clinical Pharmacology

Background:

  • Polypharmacy is a growing concern, particularly among aging populations.
  • Previous research suggests a link between multiple medications and cognitive decline, but robust population-based evidence is limited.
  • Understanding these associations is crucial for patient safety and effective healthcare.

Purpose of the Study:

  • To investigate the association between polypharmacy and cognitive impairment, including all-cause dementia (ACD), Alzheimer's disease (AD), and mild cognitive impairment (MCI).
  • To identify specific high-risk medication groups contributing to cognitive decline.
  • To examine the dose-dependent relationship between the number of medication groups and cognitive outcomes.

Main Methods:

  • A nested case-control study design was employed using electronic health records from a Southeast Texas neurology practice.
  • Data included 508 ACD patients, 149 AD patients, 579 MCI patients, and 730 cognitively healthy controls.
  • Statistical analyses, including odds ratios (ORs) and confidence intervals (CIs), were used to assess associations between cognitive outcomes and medication use, controlling for clinical and demographic variables.

Main Results:

  • Several medication classes, including antipsychotics, antidepressants, benzodiazepines, antihypertensives, and dopaminergics, were significantly associated with increased odds of all cognitive outcomes.
  • Corticosteroids were linked to higher odds of ACD and AD, while non-benzodiazepine hypnotics and anticonvulsants were associated with MCI.
  • A strong, dose-dependent relationship was observed between polypharmacy and cognitive impairment. Individuals using ≥10 medication groups showed markedly elevated odds of ACD, AD, and MCI.

Conclusions:

  • Polypharmacy and hyperpolypharmacy are significantly associated with increased odds of all-cause dementia, Alzheimer's disease, and mild cognitive impairment.
  • Specific medication groups pose higher risks for cognitive decline.
  • Regular medication reviews are essential for cognitively vulnerable populations to mitigate risks associated with polypharmacy.