The Effects of Medications on the Elderly

The physical effect of medications on the oldest old population is a concept that has never been fully researched. Many elderly persons who belong in this oldest old category, ages being 80 years or older, are often on several medications for many different ailments. Many studies have been performed to show the interaction of several medications but there have not been many studies performed to show the effect of these drug interactions on the physical ability of the person. A study conducted in Italy in 2003 managed to bring attention to this issue and the results were recorded in black and white for everyone to see. Needless to say, this certainly brought in a new awareness to many medical professionals and families across the world.

The study began in October 2003 in Italy. The criterion to meet in order to be part of this study was to be at least 80 years old. By the time the study went underway, there was a total of 364 subjects.  The baseline assessments began in December 2003 and ended in September 2004. A great deal of information was provided for this study in addition to the physical activity itself. Questionnaires were given to each subject to collect information pertaining to their family history, lifestyle, physical activity, and behavior.  Information was also collected by study physicians who recorded the subject’s clinical diagnosis based on information from the patient and their general practitioner. The information that was collected from the general practitioners included results from physical examinations, lab results, x-rays, and previous medical history. Behavioral problems were also considered but only to a degree where the subject had a least one of the following symptoms and to the point that the family was not able to modify it: wandering, verbal abuse, physical abuse, socially inappropriate behavior, and resistance to care.

The physical performance part of the study was assessed with certain types of physical activities. The subjects were to perform timed tests involving 4-m walking speed, balance, and chair stand tests. Assessments were also made for muscle strength and functional status. The functional status tests measured the ability to do the following tasks: eating, dressing, personal hygiene, mobility in bed, dressing, ability to get up from a chair or bed, use of the toilet, meal preparation, shopping, telephone use, housekeeping, responsibility for medication intake, handling finances, and use of transportation.

Trained study personnel collected information about the subject’s mediation use. They were asked if they had taken any type of medication in the two weeks prior to the beginning of the study and if they were currently taking any medications, prescribed or bought over the counter. All medications were noted and documented for the sake of the study being performed. Once all of the information was gathered and the physical tests were performed, the collected information was then documented and analyzed. The outcome showed many similar traits for subject’s that were taking many medications inappropriately for their age and/or conditions being treated. The combination of the medication and the adverse effects was very clear to see once all the information was provided on paper.

The outcome of the study, the first to show the effects of inappropriate use of medications for the oldest old, was outstanding. For the results of the 4-m walking speed test, the physical activity dropped notably when a subject was taking one or more inappropriate medications. The results came out the same for all the other noted physical activity tests that were performed. In conclusion, those of the oldest old who suffer from the effects of adverse drug interactions are less physically able to perform many of the daily activities that would allow them to live a more productive life. This inability causes them to be less active in the community which also leads to a higher mortality rate and a higher hospitalization rate. Ultimately they live a poorer quality of life. Medical doctors should seek for the best quality of life for their patients and pay closer attention to the medications and the interaction of medications that are being prescribed to their patients. This would be a greater act of kindness and for the best interest of the patient themselves.