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Pharmacokinetic basis of age-related changes in sensitivity to toxicants.

The elderly represent the fastest growing segment of the population in the United States and other developed countries. Demographic studies estimate that 20% of the population will be "elderly", over the age of 65, by the year 2030 (1). This represents a gradual increase from 1950 to 1980 when 8% and 12%, respectively, of the population were 65 or older (2). Those aged 85 and over constitute the fastest growing segment of the population and this segment is expected to triple between 1980 and 2020 (3). In fact, a life expectancy of 81 years for females and 73 years for males appears likely within the next 10 years (4). Since the elderly have the highest incidence of illness, they require a disproportionate share of health care services. As an example, the elderly as a group are the major users of prescription drugs (5), The incidence of idiosyncratic or adverse drug reactions in this group is elevated as compared to the general population (6-8). While this may be due in part to issues of polypharmacy and compliance (9, 10), both the nature of drug response as well as the frequency of adverse drug reactions clearly increase with age (11,