Dosing Considerations in Older Adults

Drug and dose selection in older adults is a complex process. Ensuring an optimal regimen may involve considerations beyond those that are immediately obvious. Factors affecting dosing in older adults vary across a wide spectrum and include changes to pharmacokinetics, pharmacodynamics, cognitive abilities, financial constraints, functional deficits, varying treatment-specific endpoints, and availability of evidence-based medicine. This chapter reviews these concepts and outlines the thought processes that clinicians should consider while making their dosing decisions. Recommendations to address these issues often include a combination of interventions and may require some creativity on behalf of the family, caregiver, and health care professionals. These factors should be considered during product development and could result in improved care of older adults.