Research Challenges, New Drug Development, Preclinical and Clinical Trials in the Ageing Population

Aging Biology and Geriatric Clinical Pharmacology

“…However, the effects of age on the pharmacodynamic effects of drugs acting on those receptors are less well established (Scarpace, 1988;Abernethy, 1990).…”

“…Recruitment of older subjects is more difficult; participation rates are 97% for children, 75% for persons aged 21 to 65 years, and less than 60% for persons aged 60 years (Zimmer et al, 1985). Various suggestions have been forwarded as methods of facilitating clinical trials in geriatric subjects (Williams and Retchin, 1984;Zimmer et al, 1985;Abernethy, 1990;Abernethy and Azarnoff, 1990;Applegate and Curb, 1990). These include increased academic links with residential care facilities and larger trials that can cope with heterogeneous populations with multiple comorbidities and heterogeneity in disease progression (Zimmer et al, 1985;Applegate and Curb, 1990).…”

Serum Concentrations of Antidepressants in The Elderly

“…6,7 In the elderly, ADRs have been linked to approximately 10% of hospital admissions and almost one-fifth of the deaths during hospitalization. 14,15 For many drugs, including antidepressants, specific dosage recommendations for the elderly in the respective product information are often missing, and little is known about the serum concentrations obtained in older versus younger patients in regular clinical practice. 12,13 During drug development, dose-escalating studies are mainly based on healthy, younger populations, despite that a major proportion of the potential users are older patients with reduced organ function.…”

Evidence, Ethics and Medication Management in Older People

“…8 Although the benefits of appropriately prescribed and monitored medications are established, this must be balanced against the fact that the incidence of adverse drug reactions increases with age. 9,10 In older people, 20% of hospital admissions are medicationrelated, impaired cognitive and physical function are associated with drug burden, and adverse drug reactions and polypharmacy are associated with increased mortality. 7,11,12 Clearly, a better framework than evidencebased medicine is needed for prescribers and health professionals involved in improving the outcomes of older people who are prescribed medications.…”