Improving drug treatment for the elderly

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Elderly patients often need drugs but are also susceptible to side effects. Kristina Johnell at the Aging Research Center researches the use of drugs among older people and how it can be optimised.

Kristina Johnell, Professor of Geriatric Pharmacoepidemiology at the Department of Neurobiology, Care Sciences and Society

Professor Kristina JohnellAs we age, we are more likely to suffer adverse reactions to medications. This is due both to the fact that increasing age correlates with more co-morbidities and medication use, and to age-related physiological changes, such as slower excretion of drugs from the body and a greater sensitivity of the brain to drug effects.

Kristina Johnell researches drug use in the elderly population, what consequences it has and how it can be improved.

“We usually take more drugs with advancing age and frailty,” says Professor Johnell. “About forty percent of people aged 65 years and older living at home take five or more drugs, a figure that rises to about 75 percent for those in sheltered housing. At the same time, we know that the multimorbid elderly on multiple medications are often excluded from clinical trials. All this makes it extremely important that proper studies are conducted of drug use among older people.”

Professor Johnell mainly bases her research on large registries, and often on the National Board of Health and Welfare’s “Indicators of appropriate drug therapy in the elderly”, which identifies the drugs that are considered problematic for elderly patients.

“The indicators provide solid ground to work from, but these types of indicators are often necessarily based on expert consensus, given the general lack of evidence from clinical trials. What we aim to do with our research is to fill this knowledge gap. For instance, we’ve been able to demonstrate a link between inappropriate drug treatment and a higher degree of hospitalisation in the elderly,” she says.

Text: Anders Nilsson, first published in "From Cell to Society" 2016.