Anti-Inflammatory and Antioxidant Strategies in Epilepsy: From Molecular Mechanisms to Threshold Management.

By the end of 2021, China’s population aged 65 and older reached 191 million, representing 13.5% of the total population and accounting for one in four older adults globally. This rapid demographic shift brings a significant and growing burden of disease. On average, older adults in China live with health conditions for over eight years. More than 190 million older Chinese individuals have chronic diseases, with 75% of the elderly population managing at least one chronic condition []. The treatment of chronic diseases in this population is often centered on a single-disease framework. However, as the number of comorbidities increases, older patients frequently require multiple medications simultaneously, a situation defined as polypharmacy when five or more drugs are used concurrently []. Advancing age is associated with pharmacokinetic and pharmacodynamic changes that elevate the risk of drug–drug and drug–disease interactions. When a medication’s potential for harm outweighs its expected benefits, it is classified as a potentially inappropriate medication (PIM) []. Adverse drug reactions (ADRs) resulting from PIMs are linked to severe clinical outcomes, including increased mortality, fractures, falls, and hospital readmissions. PIMs are the third leading cause of hospitalization among older adults and the primary cause of hospital-acquired conditions, significantly diminishing their quality of life [,,,]. Inpatient medication management for older adults is typically under the close supervision of a healthcare team, which allows for real-time monitoring and dynamic adjustments to treatment regimens. In contrast, the long-term use of medications by older outpatients is largely self-managed or overseen by caregivers, without the direct, continuous support of healthcare professionals. This lack of oversight increases the likelihood of medication errors, such as incorrect or missed doses, which in turn elevates the risk of PIMs []. Studies have shown that the mortality risk associated with PIMs is higher in older outpatients (50 per 1000) compared to inpatients (39 per 1000) [,].