Drugs and the Elderly

How Does Aging Affect Medication Use?

Despite the eternal search for the "fountain of youth," there are no medications that prevent or "cure" aging. The drugs used by the elderly are the same as those that a younger person might take--yet they can have a far different effect. It doesn't matter whether a person has heart disease or arthritis, osteoporosis, or high blood pressure, the story is the same: Because our organ systems tend to function less efficiently as we age, medications are handled differently by our bodies. Here are some of the most common changes affecting our health and our response to medicines:

• Our stomachs may not absorb food and medication as well as they did before.
• Our kidneys and livers don't eliminate fluids and toxins in the same efficient manner.
• Skin "dries up," making us more vulnerable to bruises.
• Our lung capacity diminishes, which increases risk of pneumonia and diseases caused by smoking or air pollution (emphysema).
• Muscles and joints weaken and wear out, making injury to hips, legs, and wrists more likely from even a simple fall.
• The heart and circulatory system loose peak efficiency.
• The senses we depend on--hearing, sight, taste--change subtly and affect mobility (driving a car) or pleasure (sexuality).
• The body's weight and composition changes, so that "usual" doses of medication require adjustments.
• Our immune systems decline, making us more prone to both infection and cancer.
• Our memories may deteriorate as chemical changes or clogged arteries cause brain cell damage.

All of the above contribute to the potential harm that medications can cause in the aging body. If a kidney can't eliminate a drug after it has done its work, it remains in the body longer, perhaps causing an overdose or an adverse effect. If someone forgets to take a medication that regulates the heart or blood pressure, a stroke or heart attack could be the result.

Any person over the age of 65 who is taking medications in the following categories should be aware of the potential for increased side effects, overdose, and diminished efficacy:

• Antibiotics
• Antihistamines
• Antihypertensives
• Antiulcer medicines
• Blood thinners
• Bronchodilators
• Calcium or potassium supplements
• Cardiac medications
• Corticosteroids
• Estrogens
• Over-the-counter drugs containing alcohol (cough and cold medications) or caffeine
• Pain relievers
• Psychiatric medications
• Skin medications and creams

Next: Aging, Mental Health and Medications