Medications affecting functional status in older persons.
Current evidence suggests that functional status is an important outcome of pharmacologic treatments in older people. At the moment, studies have shown diverse effects of medications on functional status. For example, some have shown potentially detrimental effects, while others have found improvements on physical function in elders. Overall, suboptimal prescribing and the occurrence of adverse drug reactions (ADRs) may negatively affect functional status. The use of selected drugs acting on central nervous system (CNS), e.g. benzodiazepines and antipsychotics, is generally associated with an increased risk of functional decline. The greater sensitivity of older people to these drugs, together with age-related changes in pharmacokinetics and pharmacodynamics, account for the observed detrimental effect and suggests a cautious approach to older and frail patients when prescribing CNS agents. On the other hand, selected drugs may slow or delay functional decline in older people. In particular, drugs aimed at targeting sarcopenia (loss in muscle mass and strength), such as testosterone in androgen deficiency, ACE-inhibitors, vitamin D and β-hydroxy β-methyl butyrate (HMB), as well as the recently developed selective androgen receptor modulators (SARMs) may hold extreme importance. This review will provide available evidence of the diverse impacts of drug medications on functional status in older persons.
Andrea
A
Corsonello
Graziano
G
Onder
Marcello
M
Maggio
Francesco
F
Corica
Unit of Geriatric Pharmacoepidemiology, Research Hospital of Cosenza, Italian National Research Center on Aging (INRCA), C. da Muoio Piccolo, I-87100 Cosenza, Italy. andrea_corsonello@tin.it.
Fabrizia
F
Lattanzio
D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D000818:Animals; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D016330:Frail Elderly; D006801:Humans; D004364:Pharmaceutical Preparations / Q000008:administration & dosage*; D010818:Practice Patterns, Physicians' / Q000592:standards; D012307:Risk Factors; D055948:Sarcopenia / Q000188:drug therapy / Q000209:etiology
D004364:Pharmaceutical Preparations