Integrated approach to reducing polypharmacy in older people: exploring the role of oxidative stress and antioxidant potential therapy

Abstract

Increased life expectancy, attributed to improved access to healthcare and drug development, has led to an increase in multimorbidity, a key contributor to polypharmacy. Polypharmacy is characterised by its association with a variety of adverse events in the older persons. The mechanisms involved in the development of age-related chronic diseases are largely unknown; however, altered redox homeostasis due to ageing is one of the main theories. In this context, the present review explores the development and interaction between different age-related diseases, mainly linked by oxidative stress. In addition, drug interactions in the treatment of various diseases are described, emphasising that the holistic management of older people and their pathologies should prevail over the individual treatment of each condition.

Oxidative Stress in Sepsis: A Focus on Cardiac Pathology

“…Other hypotheses have begun to emerge, attributing a crucial role in the pathogenesis of sepsis to biochemical dysfunctions in cellular oxygen consumption [ 7 , 8 ]. For example, studies in which oxygen administration at supraphysiological concentrations did not improve patient outcomes [ 9 ], and since mitochondrial O 2 consumption represents 90% of total body consumption, mitochondrial dysfunction could be called into question to explain the phenomenology of sepsis.…”

“…Oxygen metabolism is, indeed, involved in redox reactions which are essential for the physiological function of cells, in balance between oxidants and antioxidants. It suffices to say that oxidants regulate the formation of deoxyribonucleotides [ 9 ]. The free radicals, which are generated during these reactions belonging to the reactive oxygen species (ROS), are also involved in the body’s defense reaction against bacterial infections, both directly and indirectly by acting on vascular tone, cell adhesion, and oxygen concentration [ 10 ].…”

Interactive association of the dietary oxidative balance score and cardiovascular disease with mortality in older adults: evidence from NHANES

“…With advancing age, there has been an increase in the production of reactive oxygen species (ROS) and a corresponding decrease in the activity of enzymatic antioxidant systems, rendering older adults more susceptible to oxidative damage. 3 The accumulation of oxidative stress is intricately linked with inflammation, mutually reinforcing each other, thereby leading to cellular deterioration in individuals. 4 This process exerts a significant impact on the homeostatic systems of the body, potentially contributing to the increased incidence of age-related diseases and mortality.…”