The impact of advanced age on gastrointestinal characteristics that are relevant to oral drug absorption: An AGePOP review
Cordula Stillhart, Adam Asteriadis, E.N. Bocharova, Gabriël Eksteen, Fritz Harder, Jonas Kusch, Theodora Tzakri, Patrick Augustijns, Christophe Matthys, Maria Vertzoni, Werner Weitschies, Christos Reppas
Abstract
The purpose of this review is to summarize the current knowledge on three physiological determinants of oral drug absorption, i.e., gastric emptying, volumes and composition of luminal fluids, and intestinal permeability, in the advanced age population, so that potential knowledge gaps and directions for further research efforts are identified. Published data on gastric emptying rates in older people are conflicting. Also, there are significant knowledge gaps, especially on gastric motility and emptying rates of drugs and of non-caloric fluids. Compared with younger adults, volumes of luminal contents seem to be slightly smaller in older people. Our understanding on the impact of advanced age on luminal physicochemical characteristics is, at best, very limited, whereas the impact of (co)morbidities and geriatric syndromes in the advanced age population has not been addressed to date. The available literature on the effect of advanced age on intestinal permeability is limited, and should be approached with caution, primarily due to the limitations of the experimental methodologies used.