Many doctors are careful to ensure that people over 65 do not take what are called “potentially inappropriate medications,” referring to those remedies that are no longer effective due to advancing age.
“If a drug works efficiently when you are 40 or 50 years old, it could also do more harm than good after age 65 and many patients are not aware that this can become a serious problem”says epidemiologist A. Kulshreshtha, from Emory University (USA).
In August 2023, JAMA Network magazine conducted and published research indicating that 37% of adults over 65 years of age around the world (almost 4 out of 10) received medications that were not appropriate for the age they were.
As age advances, the body’s metabolic rate generally slows down, the motility of the digestive system decreases, changes are generated in key functions of the liver to metabolize the remedies and in the kidneys to eliminate them, so they can slowly accumulate in the body generating an action comparable to that of an increase in the dose.
At the same time, natural changes in vision, hearing and bone density are added, which can help older adults to be more sensitive to the adverse effects of drugs that at another time were not present.
The risk of “polypharmacy”
It is also common for older adults to simultaneously consult various experts and, frequently, each of them indicates a medication that they consider necessary.
It is one of the frequent reasons for polypharmacy and an obligation for doctors to be attentive to this situation.
If a drug works effectively when you are 40 or 50, it could also do more harm than good after age 65.
It is estimated that 90% of adults over 65 years of age regularly take at least 1 prescription medication80% take at least 2 prescription medications and 36% take at least 5 different prescription medications.
These percentages increase if dietary supplements and over-the-counter products are included.
In this framework, medications that block the action of acetylcholine, a neurotransmitter that is key to having a good memoryattention, concentration, which regulates the functioning of the heart, arteries, bronchi, bladder and digestive system.
Consequently, the intake of certain drugs that block their action will cause blurred vision, dizziness, confusion, alterations in balance, difficulty urinating or having marked dry mouth, among other side effects. (To which it must be added that acetylcholine decreases under normal conditions after age 65.)
As an example, antispasmodics that have the action of blocking acetylcholine precisely attenuate spasms and contractions of the intestine thus reducing pain, at the same time they frequently cause headaches, dizziness, blurred vision or dry eyes.
Something similar happens with some tranquilizers, antidepressants, antipsychotics or antiallergy medications.
The older the age, the older the intensity and severity of the effects of acetylcholine blockade, especially at the brain level, and which is often confused with non-existent brain deterioration.
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