Problems of pharmacotherapy of elderly patients

Author:

Ushkalova E.A.

Place of publication:

Neuronyus issue No. 4 (42) 2018

By the beginning of 2013, the proportion of people aged 65 and over averaged approximately 13% in Russia, and 28% in some regions. It is projected to reach 22% of the global population by 2050. In Russia, by the beginning of 2021, the number of people aged 65 and over is expected to increase to 22.9 million, 80 and over – 5.5 million, and 100 and over – 7,266. People aged 80 and over are the fastest growing population group in economically developed countries.
Evidence-based medicine data on the efficacy and safety of medications in the elderly are extremely limited, since age >65 years remains one of the main criteria for exclusion from randomized controlled trials (RCTs).
Meanwhile, the efficacy and safety of therapy in elderly patients may differ significantly from that in middle-aged and younger individuals, due to age-related physiological changes that alter the pharmacokinetics and pharmacodynamics of many medications.
Other factors complicating pharmacotherapy in the elderly include frailty, somatic and mental comorbidity and associated polypharmacy, social factors (loneliness, helplessness, poverty), poor learning abilities, and poor treatment adherence.