Abstract
Elderly persons are often treated with pharmaceuticals for many different conditions, both for chronic diseases and common ailments in old age. Many prescribed medicines and herbal remedies as well as over the counter purchased drugs are frequently used in the older population. The resulting polypharmacy poses a challenge to physicians to master complicated pharmacological issues and combinations of drugs. Adverse drug effects and interactions between combinations of drugs essential for the medical treatment for chronic diseases such as high blood pressure, diabetes or osteoporosis, are some of the problems to be solved. Often the normal course of aging in the human body gives rise to ailments that should not really be treated with drugs at all. To “medicalise” aging, is to put our patients at risk in many potentially dangerous ways. Sometimes, in a long term perspective, the cure can be worse than the condition itself for the patient.
In this chapter common geriatric conditions will be described with special attention to the pharmacological treatment and hazards of drug treatment in the elderly.A number of frequently occurring complaints and ailments in the aging population will be described in connection with drug treatment. Gastrointestinal conditions such as constipation, peptic ulcers, gastritis and dryness of the mouth will be covered as well as kidney failure, urinary incontinence, osteoporosis, falls and fractures, sarcopenia, orthostatic hypotension and vertigo. These chosen examples are conditions that can be treated with, and often should be treated with, drugs. But what are the drawbacks to this?
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Ades PA, Ballor DL, Ashikaga T et al. (1996) Weight training improves walking endurance in healthy elderly persons. Ann Intern Med 124(6): 568–572
Andersson KE (1997) The overactive bladder: pharmacologic basis of drug treatment. Urology 50(6A Suppl): 74–84
Ashley C (2004) Renal failure – how drugs can damage the kidney. Hosp Pharmacist 11: 48–53
Bakris GL and Kern SR (1989) Renal dysfunction resulting from NSAIDs. Am Fam Physician 40(4): 199–204
Binder EF, Yarasheski KE, Steger-May K et al. (2005) Effects of progressive resistance training on body composition in frail older adults: results of a randomized, controlled trial. J Gerontol A Biol Sci Med Sci 60(11): 1425–1431
Blalock SJ, Byrd JE, Hansen RA et al. (2005) Factors associated with potentially inappropriate drug utilization in a sample of rural community-dwelling older adults. Am J Geriatr Pharmacother 3(3): 168–179
Brignole M (1998) Progressive orthostatic hypotension in the elderly. J Neurol Neurosurg Psychiatry 65: 285–289
Chapple CR (2000) Muscarinic receptor antagonists in the treatment of overactive bladder. Urology 55(5A Suppl): 33–46
Colledge NR, Wilson JA, Macintyre CC et al. (1994) The prevalence and characteristics of dizziness in an elderly community. Age Ageing 23(2): 117–120
The Consensus Committee of the American Autonomic Society and the American Academy of Neurology. (1996) Consensus statement on the definition of orthostatic hypotension, pure autonomic failure, and multiple system atrophy. Neurology 46(5): 1470
Cooper C, Atkinson EJ, Jacobsen SJ et al. (1993) Population-based study of survival after osteoporotic fractures. Am J Epidemiol 137(9): 1001–1005
Cummings SR and Melton LJ (2002) Epidemiology and outcomes of osteoporotic fractures. Lancet 359(9319): 1761–1767
Davis LE (1994) Dizziness in elderly men. J Am Geriatr Soc 42(11): 1184–1188
Doherty TJ (2003) Invited review: Aging and sarcopenia. J Appl Physiol 95(4): 1717–1727
Dutta C (1997) Significance of sarcopenia in the elderly. J Nutr 127(5 Suppl): 992S–993S
Evans WJ (1995) Effects of exercise on body composition and functional capacity of the elderly. J Gerontol A Biol Sci Med Sci 50 Spec No: 147–150
Faisal MA, Russell RM, Samloff IM et al. (1990) Helicobacter pylori infection and atrophic gastritis in the elderly. Gastroenterology 99(5): 1543–1544
Gillespie LD, Gillespie WJ, Robertson MC et al. (2009) Interventions for preventing falls in elderly people. Cochrane Database Syst Rev 15(2): CD000340
Griffin MR, Yared A, Ray WA (2000) Nonsteroidal antiinflammatory drugs and acute renal failure in elderly persons. Am J Epidemiol 151(5): 488–496
Gulmez SE, Holm A, Frederiksen H et al. (2007) Use of proton pump inhibitors and the risk of community-acquired pneumonia: a population-based case-control study. Arch Intern Med 167(9): 950–955
Hampel C, Wienhold D, Benken N et al. (1997) Prevalence and natural history of female incontinence. Eur Urol 32(Suppl 2): 3–12
Henry D, Page J, Whyte I et al. (1997) Consumption of non-steroidal anti-inflammatory drugs and the development of functional renal impairment in elderly subjects. Results of a case-control study. Br J Clin Pharmacol 44(1): 85–90
Hernández-Diaz S and García-Rodriguez LA (2000) Association between nonsteroidal anti-inflammatory drugs and upper gastrointestinal tract bleeding/perforation: an overview of epidemiologic studies published in the 1990s. Arch Intern Med 160(14): 2093–2099
Howe TE, Rochester L, Jackson A et al. (2007) Exercise for improving balance in older people. Cochrane Database Syst Rev 17(4): CD004963
Jackson S (1997) The patient with an overactive bladder – symptoms and quality-of-life issues. Urology 50(6A Suppl): 18–22
Janssen I, Shepard DS, Katzmarzyk PT et al. (2004) The healthcare costs of sarcopenia in the United States. J Am Geriatr Soc 52(1): 80–85
Johnson DA and Fennerty MB (2004) Heartburn severity underestimates erosive esophagitis severity in elderly patients with gastroesophageal reflux disease. Gastroenterology 126(3): 660–664
Jonsson R, Sixt E, Landahl S et al. (2004) Prevalence of dizziness and vertigo in an urban elderly population. J Vestib Res 14(1): 47–52
Kanis JA, Johnell O, De Laet C et al. (2002) International variations in hip fracture probabilities: implications for risk assessment. J Bone Miner Res 17(7): 1237–1244
Kemppainen H, Raiha I, Sourander L (1997) Clinical presentation of peptic ulcer in the elderly. Gerontology 43(5): 283–288
Koski K, Luukinen H, Laippala P et al. (1996) Physiological factors and medications as predictors of injurious falls by elderly people: a prospective population-based study. Age Ageing 25(1): 29–38
Kragh A (2004) [Two out of three persons living in nursing homes for the elderly are treated with at least ten different drugs. A survey of drug prescriptions in the northeastern part of Skane]. Lakartidningen 101(11): 994–996
Laine L, Ahnen D, McClain C et al. (2000) Review article: potential gastrointestinal effects of long-term acid suppression with proton pump inhibitors. Aliment Pharmacol Ther 14(6):651–668
Leipzig RM, Cumming RG, Tinetti ME (1999a) Drugs and falls in older people: a systematic review and meta-analysis: I. Psychotropic drugs. J Am Geriatr Soc 47(1): 30–39
Leipzig RM, Cumming RG, Tinetti ME (1999b) Drugs and falls in older people: a systematic review and meta-analysis: II. Cardiac and analgesic drugs. J Am Geriatr Soc 47(1): 40–50
Manes G, Pieramico O, Uomo G et al. (2003) Relationship of sliding hiatus hernia to gastroesophageal reflux disease: a possible role for Helicobacter pylori infection? Dig Dis Sci 48(2): 303–307
Mathias CJ and Kimber JR (1998) Treatment of postural hypotension. J Neurol Neurosurg Psychiatry 65(3): 285–289
Matzke GR and Frye RF (1997) Drug administration in patients with renal insufficiency. Minimising renal and extrarenal toxicity. Drug Saf 16(3): 205–231
McConnell EJ, Tessier DJ, Wolff BG (2003) Population-based incidence of complicated diverticular disease of the sigmoid colon based on gender and age. Dis Colon Rectum 46(8): 1110–1114
Montastruc JL, Laborie I, Bagheri H, Senard JM (1997) Drug-induced orthostatic hypotension: a five-year experience in a regional pharmacovigilance centre in France. Clin Drug Invest 14(1): 61–65
Mouly S, Salom M, Tillet Y et al. (2007) Management of xerostomia in older patients: a randomised controlled trial evaluating the efficacy of a new oral lubricant solution. Drugs Aging 24(11): 957–965
Murakami T, Kawamata K, Tatekawa I et al. (1968) Gastric ulcer in elderly patients. J Gastroent 3(4): 284–285
NIH (2000) Osteoporosis prevention, diagnosis, and therapy. NIH Consensus Statement 17(1): 1–45
Oldenburg O, Kribben A, Baumgart D et al. (2002) Treatment of orthostatic hypotension. Curr Opin Pharmacol 2(6): 740–747
Payne CK (1998) Epidemiology, pathophysiology and evaluation of urinary incontinence and overactive bladder. Urology 51: 3–10
Pavri BB and Ho RT (2003) Syncope. Identifying cardiac causes in older patients. Geriatrics 58(5): 26–31
Pilotto A (1996) Helicobacter pylori infection in the elderly. Clin Geriatr 4: 53–70
Pilotto A, Franceschi M, Valerio G et al. (1999) Helicobacter pylori infection in elderly patients with peptic ulcer. Age Ageing 28(4): 412–414
Podoleanu C, Maggi R, Brignole M et al. (2006) Lower limb and abdominal compression bandages prevent progressive orthostatic hypotension in elderly persons: a randomized single-blind controlled study. J Am Coll Cardiol 48(7): 1425–1432
Ship JA, Pillemer SR, Baum BJ (2002) Xerostomia and the geriatric patient. J Am Geriatr Soc 50(3): 535–543
Talley NJ, O’Keefe EA, Zinsmeister AR et al. (1992) Prevalence of gastrointestinal symptoms in the elderly: a population-based study. Gastroenterology 102(3): 895–901
Thomson WM, Chalmers JM, Spencer AJ et al. (2000) Medication and dry mouth: findings from a cohort study of older people. J Public Health Dent 60(1): 12–20
Tinetti ME (2003) Clinical practice. Preventing falls in elderly persons. N Engl J Med 348(1): 42–49
Tramonte SM, Brand MB, Mulrow CD et al. (1997) The treatment of chronic constipation in adults. A systematic review. J Gen Intern Med 12(1): 15–24
Turner MD and Ship JA (2007) Dry mouth and its effects on the oral health of elderly people. J Am Dent Assoc 138(Suppl): 15S–20S
Uneri A and Polat S (2008) Vertigo, dizziness and imbalance in the elderly. J Laryngol Otol 122(5): 466–469
Verhaeverbeke I and Mets T (1997) Drug-induced orthostatic hypotension in the elderly: avoiding its onset. Drug Saf 17(2): 105–118
Wagner TH and Hu TW (1998) Economic costs of urinary incontinence in 1995. Urology 51(3): 355–361
WHO (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843: 1–129
Yang YX, Lewis JD, Epstein S et al. (2006) Long-term proton pump inhibitor therapy and risk of hip fracture. JAMA 296(24): 2947–2953
Zullo A, Hassan C, Campo SM et al. (2007) Bleeding peptic ulcer in the elderly: risk factors and prevention strategies. Drugs Aging 24(10): 815–828
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
Copyright information
© 2009 Springer Science+Business Media B.V.
About this chapter
Cite this chapter
Midlöv, P., Eriksson, T., Kragh, A. (2009). Drugs and Common Health Conditions in Old Age. In: Drug-related problems in the elderly. Springer, Dordrecht. https://doi.org/10.1007/978-90-481-2446-6_5
Download citation
DOI: https://doi.org/10.1007/978-90-481-2446-6_5
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-90-481-2445-9
Online ISBN: 978-90-481-2446-6
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)