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Physiologic changes in old age: relation to altered drug disposition

D J Greenblatt, M Divoll, D R Abernethy

    Journal of the American Geriatrics Society
    |November 1, 1982
    PubMed
    Summary

    Aging does not impair drug absorption in older adults. However, changes in body composition and liver metabolism (Phase I reactions) can alter drug distribution and processing, impacting pharmacokinetics.

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    Area of Science:

    • Pharmacology
    • Gerontology
    • Drug Metabolism

    Background:

    • Aging significantly impacts physiological functions, including drug disposition.
    • Understanding age-related changes in drug metabolism is crucial for safe and effective pharmacotherapy in the elderly.

    Purpose of the Study:

    • To review current knowledge on how aging affects drug disposition.
    • To identify key pharmacokinetic changes associated with aging.

    Main Methods:

    • Literature review of studies on aging and drug disposition.
    • Analysis of evidence regarding drug absorption, distribution, and metabolism in the elderly.

    Main Results:

    • Drug absorption appears unaffected by aging.

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  • Drug distribution may be altered due to changes in body composition (lipid/lean mass ratio).
  • Phase I liver biotransformation is more profoundly affected by aging than Phase II reactions.

    • Conclusions:

    • Aging alters drug distribution and hepatic metabolism (Phase I), necessitating careful pharmacokinetic assessment.
    • Total clearance is a more relevant parameter than half-life for assessing pharmacokinetics in the elderly.