Features of pharmacotherapy in elderly and senile individuals

The relevance of studying pharmacotherapy in the elderly is due to the global aging of the population and the associated medical challenges. Elderly people suffer from multiple chronic diseases (polymorbidity), which inevitably leads to the simultaneous use of multiple drugs (polypharmacy). More than 90% of people over 65 regularly take medications, and more than half take 5 or more at a time. Age-related changes in the body (decreased liver and kidney function, changes in body composition, sensitivity of the central nervous system and cardiovascular system) radically change the pharmacokinetics and pharmacodynamics of drugs, increasing the risk of their accumulation and toxicity. The combination of polymorbidity, polypharmacy, and altered drug response creates a high risk of dangerous drug interactions (up to 87% when taking 6+ drugs), frequent and severe adverse reactions (causing 10-17% of hospitalizations), and iatrogenesis. Additional complications include a limited evidence base for this group and a significant economic burden of complications. The employment of special tools (STOPP/START criteria) to optimize therapy and prevent irrational prescriptions is a prerequisite for ensuring safe and effective treatment of the elderly.