Treatment characteristics in elderly.

The pharmacodynamics and pharmacokinetics of medications, their therapeutic and toxic effects are age dependant. In the treatment of old people polypharmacy is widely used. The most common results of polypharmacy are increased adverse drug reactions, drug-drug interactions. In this study the use of different medications at the Departments of General Medicine and Cardiology (Tbilisi Republic Hospital) was analyzed. The case histories (1995, 2000 and 2005) of 1708 patients were studied. It was found that in 2005 the number of 60 years and older patients has doubled comparably with 1995, but the number of 24-44 years old patients remained almost the same. The complication rate was higher in elderly as compared with younger patients. It was found that in treatment of elderly population hypotensive drugs, diuretics and cardiac glycosides are used excessively. In the case of excess use of antihypertension medications there is a big risk of developing arterial hypotension. In old people it may lead to orthostatic hypotension, in youth - to dizziness. The frequent use of diuretics in old people may be accompanied with dehydration and risk of developing thromb formation. Hyponatraemia, hypokalaemia, hypomagnesemia lead to heart rhythm disturbances and risk of glycoside intoxication. In old people the therapeutical doses of diuretics depend not only on their biological activity, but also on the ability of their absorption from the gastrointestinal tract, on the organism's resistance and in the case of repeated intake on their cumulation quality and extraction.

Age-related changes of sex hormones--level among males in populations with high index of longevity.

The phenomenon of longevity as a kind of model of "physiological" aging has been the main research subject of the Department of Gerontology Institute of Morphology (Georgia) since 1970. The researches were conducted under the Multiplan complex program "Bio-anthropological and social and ethnic investigation of nations and ethnic groups with high index of longevity" in the "long-liver" populations of Georgia. The research aimed at studying the changes in the content of the sex steroids and gonadotrophic hormones in the blood plasma of the healthy men aged from 45 to 90 and more years and residing in Georgia. The control reference group consisted of healthy man, aged from 22 to 35 years. In the blood of patients of all age groups there was observed the fall of the testosterone concentration by 34-55% as compared to the control group and growth of the content of luteinizing hormones by 1-10%. There was not observed falling of the testosterone concentration below the normal limits in any age group (11 nmol/l). Therefore, syndrome of partial progressive insufficiency of the androgens is the reality and requires clear therapeutic treatment attitudes and development of substitutive hormonotherapy.

Genetic study of high longevity index populations.

Five-year multidisciplinary study of longevity in the Georgian SSR made it possible to select two populations (Abkhazian and Imeretian), in which indices of longevity were much higher, than the average level for the rural population of the whole region. The distribution of polymorphic systems of red cell enzymes (adenilate kinase, esterase D, phosphoglucomutase I, acid phosphatase, 6-phosphogluconate dehydrogenase, glyoxalase I, lactate dehydrogenase, adenosine deaminase, glutamate pyruvate transaminase, phosphoglycolate phosphatase, phosphohexose isomerase) and serum proteins (haptoglobin, Gc-component and transferrin) was studied for genetic analysis of these populations. The results indicate that for all the studied loci the observed genotypic frequencies in both populations are distributed according to Hardy-Weinberg equilibrium. The genetic comparison of the studied populations with some other neighbouring populations did not reveal any genetic peculiarities and the both populations concord with the scheme of anthropological types of Hither Asia. The study of age-related changes of gene frequencies and heterozygosity showed some age-related fluctuations of genetic indices in all age groups, but the heterogeneous nature of these deviations indicate that they may be the result of random genetic processes.