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Review
. 2024 Dec;29(1):2289740.
doi: 10.1080/13510002.2023.2289740. Epub 2023 Dec 18.

Integrated approach to reducing polypharmacy in older people: exploring the role of oxidative stress and antioxidant potential therapy

Catalina Rojas-Solé  1 , Víctor Pinilla-González  1 , José Lillo-Moya  1 , Tommy González-Fernández  1 , Luciano Saso  2 , Ramón Rodrigo  1
Affiliations
Review

Integrated approach to reducing polypharmacy in older people: exploring the role of oxidative stress and antioxidant potential therapy

Catalina Rojas-Solé et al. Redox Rep. 2024 Dec.

Abstract

Increased life expectancy, attributed to improved access to healthcare and drug development, has led to an increase in multimorbidity, a key contributor to polypharmacy. Polypharmacy is characterised by its association with a variety of adverse events in the older persons. The mechanisms involved in the development of age-related chronic diseases are largely unknown; however, altered redox homeostasis due to ageing is one of the main theories. In this context, the present review explores the development and interaction between different age-related diseases, mainly linked by oxidative stress. In addition, drug interactions in the treatment of various diseases are described, emphasising that the holistic management of older people and their pathologies should prevail over the individual treatment of each condition.

Keywords: Polypharmacy; ageing; antioxidants; frailty; geriatrics; inflammaging; multimorbidity; oxidative stress.

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Conflict of interest statement

No potential conflict of interest was reported by the author(s).

Figures

Figure 1.
Figure 1.
Molecular mechanism of oxidative stress and potential targets for antioxidant treatment in aging-related diseases. ARE, antioxidant response elements; CAT, catalase, GLP-1, glucagon-like peptide 1;GPX, glutathione peroxidase; GST, glutathione transferase; HO-1, heme oxygenase 1; Keap1, Kelch-like ECH-associated protein 1; NF-κB, nuclear factor kappa-light-chain-enhancer of the activated B cells; Nrf2, nuclear factor-erythroid 2-related factor 2; NSAIDs, non-steroidal anti-inflammatory drugs; ROS, reactive oxygen species; SOD, superoxide dismutase.
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Grants and funding

This manuscript was funded by N◦ 1211850 of the Agencia Nacional de Investigación y Desarrollo (ANID). This institution did not participate in the design, literature review, or writing of the manuscript.