About this Research Topic

Background

Over the last decades, there has been a substantial progress in the pharmacological prevention and treatment of several diseases, which could partially account for the increase in population’s age worldwide.

Healthy ageing depends on many factors, and neurodegenerative diseases, especially of cognitive type, belong to the cluster of non-communicable diseases as major determinants of health-related quality of life.

Pharmacological therapy remains however elusive and current approaches often address only symptoms and are long-delayed. In addition, several conditions have been implicated in the development and progression of cognitive impairment, including risk genes, metabolic perturbations, chronic inflammation, infections, vascular factors and mood disorders. Therefore, comorbidities and associated pathways could serve as major therapeutic targets in the future, for example to help alleviate side effects.

Translational studies revealed that some medications are potentially inappropriate in advanced age, despite the development of certain healthcare guidelines like STOPP/START and Beers criteria that have been helpful in identifying adverse effects in geriatric patients and improving medical decisions regarding prescription.

Moreover, the concurrent use of multiple medications (polypharmacy) has a detrimental effect on patients’ health, resulting in a domino effect and eventually accelerating mortality. Anticholinergic drugs for example have been shown to promote cognitive impairment and increase the risk of dementia, while the benefit of statins remains debatable, especially in the elderly. There are also large discrepancies among health specialists about whether medical findings and behavioural changes should be interpreted as signs, symptoms or epiphenomena of neurodegeneration, and therefore considered for therapeutic interventions.

There are only few studies that investigate the combination of conventional medications and complementary therapies aimed to delay the illness progress or address specific clinical manifestations. Therefore, it would be advantageous to pursue a reverse translational approach, in order to identify substances of potential therapeutic value.

Taking into consideration the interrelation between the physiology of the ageing body and pharmacodynamics/pharmacokinetics (PD/PK) aspect, this Research Topic will focus on the recent advances in the field of Neuropharmacology, Pharmacoepidemiology and Geriatrics, and welcomes relevant Original Research articles based on Clinical or Experimental Pharmacology approaches, Reviews or Mini Reviews, Case Reports, Data Reports, General Commentaries, Brief Research reports and Opinion articles. This collection will cover, but won’t be limited to:

1. The assessment of both short- and long-term risks and benefits of drug therapy in people living with cognitive impairment or dementia, including regional or large cohorts, and databases analysis.

2. The investigation of relevant drug-drug interactions, and their impact on PD/PK, with special focus on polypharmacy in advanced age.

3. The pharmacological management of low- and high-grade systemic inflammation in view of its protective role against future neurodegeneration.

4. The exploration of alternative pharmacological prophylactic schemes along the course of mild cognitive impairment and dementia.

5. The determination of clinically relevant endpoints during pain and sleep pharmacological management in the course of life.

6. The integration of data regarding geriatric patient comfort, satisfaction, and adherence to multiple treatment during therapeutic interventions.

7. The investigation of drug-nutraceutical interactions, with special interest in fibres, thickeners, softeners, nutritional supplements and emulsifiers.

8. The value of biochemical and physiological markers, the development of comprehensive experimental models, and the use of databases in assessing drug effects in the elderly.

9. The impact of pharmacists on the quality of treatment in advanced age in diverse settings (community, nursing homes, hospitals).

Keywords: aging, neurodegenerative diseases, cognitive dysfunction, polypharmacy, public health

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.

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