Pharmacotherapy guidelines for the aged by family doctors for the use of family doctors: Part D Basic conditions supporting drug treatment.

Abstract

Physiological changes in old age: loss of muscle mass; reduction in bone mass; percentage of fat increased; lower amount of body water; lack of thirst; diminishing kidney function (caution: sufficient intake of fluids: 1.5-2 l and moderate intake of protein 8 g/kg body weight); reduced secretion of digestive enzymes, delayed emptying of stomach (which means premature feeling of repletion). Lack of fluids and nutrition is therefore likely. Daily intake of 1,500 kcal and 1.5-2 l fluids is necessary. An indicator for malnutrition is low body weight (defined for persons older than 65 years of age as BMI < 20) and a protein serum concentration < 35 g/l. Malnutrition carries an increased risk of infections, falling and fractures, bed sores, anemia, decompensation of chronic diseases. 10-20% of subjects over 80 years of age show signs of malnutrition, 40-60% of subjects in care institutions or hospitals. There are regressive changes in the locomotor and the nervous system of the elderly which have an effect on physical fitness. These changes reduce strength, endurance, proprioceptive capacity (e.g. coordination, balance) and mobility. Exercise in the old and very old should increase skeletal muscle strength in particular and improve coordination and balance. Regular physical exercise and moderate training has a positive effect on mobility and thereby improves independence and reduces falls. Moreover, it has a positive effect on cardiac output, maximum heart rate, stroke volume and the risk of a cardiovascular event and mortality can be reduced. Moreover, moderate physical exercise is often more effective in treating chronic disease than drug therapy e.g. heart failure, coronary heart disease, asthma/COPD, stroke, diabetes mellitus Type 2, degenerative diseases of the joints, depression and others. Examine cardiovascular risks in persons over the age of 50 before beginning physical exercise. Avoid maximum stress levels.

• Authors: F W Bergert, D Conrad, K Ehrenthal, J Fessler, J Gross, K Gundermann, B Kluthe, W Lang Heinrich, A Liesenfeld, P G Loew, E Luther, R Pchalek, J Seffrin, A Sterzing, H-J Wolfring, U Zimmermann, Guidelines Group Hesse: Pharmacotherapy Guidelines by Family Doctors for Family Doctors
• Journal: International journal of clinical pharmacology and therapeutics (Int J Clin Pharmacol Ther) Vol. 47 Issue 5 Pg. 289-302 (May 2009) ISSN: 0946-1965 [Print] Germany
• PMID: 19473591 (Publication Type: Journal Article)

Topics

• Aged
• Exercise
• Family Practice
• Humans
• Nutrition Assessment
• Nutrition Disorders (physiopathology, therapy)
• Nutritional Requirements
• Nutritional Status
• Physical Endurance
• Practice Patterns, Physicians'
• Resistance Training