TO-DAY'S DRUGS Geriatric Prescribing (i)Geriatric medicine is concerned with both acute and long-term illness in the aged.For convenience, the age of pensionable retirement is often taken as the starting line for geriatrics.The essential difference between the aged patient and the younger one is that in old age illness is either due to degenerative changes or to an acute process occurring in a person whose powers of recovery are impaired by such changes.In practice this means that the functions of some or all of the vital organs of the patient are greatly limited.This may decrease the response to stimulating drugs or increase the response to depressant drugs, and will usually slow down the rate of destruction and excretion of the drug.Geriatric patients have usually acquired many pathological changes during their long life, but usually only one of these is the immediate cause of the breakdown, with others aggravating the disability and some having no relevance to the current illness.Therapy, therefore, must be applied not to all the abnormalities found, but to those which are contributing to the illness.This means that merely to diagnose a pathological process is not enough.Its effect on the whole patient must be accurately assessed.
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Sanerkin et al. (1964) studied this question.