Drug Use In The Elderly: Risk or Protection?

Christel Cornelius


Curr Opin Psychiatry. 2004;17(6) 

In This Article


In summary, ageing leads to increased morbidity and use of drugs, resulting in a higher risk of adverse effects due to polypharmacy, interactions, and pharmacokinetic and pharmacodynamic changes, thus underlining the importance of continuously optimizing drug use in the elderly, which would minimize problems and reduce costs. Elderly persons constitute a heterogeneous group from healthy ageing individuals to individuals with multimorbidity, demanding special attention and knowledge of the prescribing physician when pharmacological treatment is needed. 'Start low, go slow' is good advice in geriatric practice. Optimum drug use in the elderly also includes avoiding undertreatment, for example of depression and of cognitively impaired and demented individuals. Depressed mood and impaired memory should not be dismissed as a normal state of ageing.

Dementia is a common disorder in the elderly, and the search for more effective therapies is challenging. To date, symptomatic treatment that hopefully postpones the disease progression can be offered to patients. Great efforts are also being made to find new and better treatment alternatives. There is hope of finding more efficient treatment in the future. Meanwhile, various already existing drugs have shown promising results as possible neuroprotective agents that may protect against the progression of dementia, including antiinflammatory drugs and treatment against hypertension and vascular risk factors. Estrogen, however, does not seem to protect against dementia, according to the findings of randomized trials so far.


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