Alcohol, Medication and Older Adults
For Those Who Care About or Care for an Older Adult

Module 3: Prescription and Over-the-Counter Medications - Page 4 of 13

Factors Contributing to Misuse

Many of the hazards associated with use of medications in older adults are due to aging-related changes. Understanding how aging affects the body's response to medication will help us see exactly how vulnerable older adults can be.

Several other factors affect a person's ability to use medications correctly and responsibly. Memory problems, sensory loss, or chronic conditions, make taking medications independently more difficult. A confusing health care system, doctors with too many patients to see, and limited resources only add to the potential for medication misuse.

Pocket Watch

Physical Effects of Aging

Aging changes the way drugs are absorbed, metabolized, distributed, and removed from the body. Some of these changes are:

Decrease in the percent of body weight composed of water
Certain medications can be more concentrated and potent in an older adult. The amount of fatty tissue increases, even though the person's total weight may remain the same. Therefore, drugs distributed in fat have a less intense, but more prolonged, effect. This is frequently seen in the "hangover" effect from sleeping medications and tranquilizers. Women are at even greater risk for these adverse effects.

Changes in digestion
Emptying of the stomach and intestinal movement slow down. Therefore, drug action may be decreased or delayed. Risk of ulcers also increases.

Changes in liver function
The liver decreases in size. Blood flow and the enzyme activity that breaks down drugs decrease. Therefore, the liver takes longer to break down some drugs. These drugs may accumulate in the body, resulting in a higher concentration of the drug.

Changes in kidney function
The kidneys also become smaller. Blood flow and filtering capacity decrease. Heart failure and anemia can further impair kidney function. Reduced kidney function causes certain drugs to leave the body more slowly. These drugs stay in the body for a longer time than expected.

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