Considerations in Drug Therapy of the Elderly

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Abstract
In the elderly, particularly the frail-old or old-old, sociogenic factors combine with the effects of primary (biologic) and secondary (pathologic) aging to produce, at times, a complex clinical picture. The elderly also face a high level of psychosocial and physical stress. In addition, the clinical presentation may be complex and difficult to diagnose, as many of the classical signs and symptoms may be absent or exacerbated. Many of the diagnostic norms may not apply to the elderly, as the concept of being well differs when comparing young with older people. Drug effects in the elderly fluctuate and are much more unpredictable. The elderly patient may present in a confusional state caused by unexplained drug effects. For varying reasons, elders suffer from unwanted drug effects more frequently than do younger adult patients. Assessment of the health status of the elderly must be based on the understanding that problems of living, general health factors, diseases of adaptation, and a decrease in the efficiency of several organ systems combine to determine that status.

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