The Elderly, Undernutrition, and Pharmacokinetics

Abstract

There is good evidence that malnutrition may alter the pharmacokinetic parameters and, thus, actions of several drugs. The elderly are probably most at risk, as malnutrition tends to affect factors already altered by primary and secondary aging.

Evaluation of inappropriate drug use in geriatric patients using the TIME-to-STOP/TIME-to-START criteria in a tertiary hospital

“…Consistent with our study, Bahat et al and Kara et al reported that chronic diseases increased the potential for inappropriate drug use in the elderly [40,41]. Furthermore, similar to our study, Sayın et al reported that polypharmacy increased potentially inappropriate drug use [42]. Another study reported no statistically significant relationship between the number of drugs used and potentially inappropriate drug use in hospitalized elderly patients [16].…”

“…Other studies have reported similar results to ours [16,40]. However, Sayın et al reported that potentially inappropriate drug use was statistically more common in patients over 75 years of age [42]. The CCI score was not associated with potentially inappropriate drug use in our study, similar to the study by Martin et al [29].…”

“…We found a higher percentage of PIM use in Turkey than in the studies mentioned above. Furthermore, unlike in our study, another study reported no inappropriate drug use according to the START criteria for elderly patients in Turkey [42]. This difference is thought to stem from the inclusion of the section on oral nutritional support in the TIME-to-START criteria [6].…”

Medicating the elderly in home health care

“…Several fac-tors contribute to the nutritional status of the elderly, including poverty, aging, chronic disease, and chronic drug therapy. [24][25] Failure to take medication represents 50% or more of the incidences of noncompliance. Reasons for noncompliance range from conscious decisions or forgetfulness to financial restrictions.…”

The Elderly and Drug Interactions

“…Long‐term administration of drugs to elderly with subclinical malnutrition can deplete the patient of specific nutrients, and the deficit may present in various ways (Table 8). 58 Malnutrition can alter the pharmacokinetics of many drugs 59 . Clearly, the elderly are more at risk for adverse and clinically important outcomes of drug‐nutrient and food‐drug interactions than are younger persons.…”