Nutritional Status and Drug Therapy in Older Adults

Abstract

The aging process is characterized by a high level of complexity with a progressive decline in several physiological systems coexisting with multiple chronic diseases (comorbidity), presence of cognitive and functional impairment and geriatric syndromes. Use of multiple drugs and problems in nutritional status are relevant components of this complex spectrum. Nutritional status may influence the pharmacokinetic and pharmacodynamic of many drugs, conversely drugs can impair nutrition by causing adverse drug reactions such as nausea and loss of appetite. The present article describes potential interactions between nutritional status and drug use in the elderly. The role of nutritional status in the pharmacokinetic of drugs (including absorption, distribution, metabolism and elimination) is reviewed and most relevant food drugs interactions are assessed. Malnutrition and nutritional problems are common conditions in older adults. Multiple chronic disease, inflammation, cognitive and functional impairment, geriatric syndromes (including delirium, falls or chronic pain) and drug use (i.e. polypharmacy, adverse drug reactions) may play a role in the onset of malnutrition and nutritional problems. In particular, drugs and nutrition are closely connected. Nutritional status may influence the pharmacokinetic and pharmacodynamic of many drugs, conversely, drugs can impair nutrition by causing adverse drug reactions such as nausea and loss of appetite. The present article will assess potential interactions between nutritional status and drug use in the elderly.