Elderly population is associated with increased and susceptibility to disease and disability. Ageing is considered as independent risk factor for atherosclerosis, cancer, and arthritis as well as for the prototypical aging diseases such as dementia and osteoporosis. Research on the understanding of ageing process offers insight into pathogenesis of various diseases and their therapeutic approach. Age-related decrease in liver function plays an important part in the systemic exposure to substrates, involved in disease pathogenesis and ageing. Earlier, it was believed that liver was unaffected by ageing and age-related diseases and functional changes, were mainly due to age-related reduction in blood flow and liver mass. Nevertheless, these mechanisms are unable to eucidate impairment of hepatic function and the systemic effects of these changes, thus evaluation into other hepatic factors such as liver blood vessel ultrastructure, immune function, and gene and protein expression is required.

The author, S. J. Mitchell et al have highlighted the role of genetic instability in age-related loss of liver function which can aid in understanding and combating diminished liver function with age. They also challenged the use of common analgesic paracetamol in older people, which makes it important to understand the risks associated with both underdosing of this analgesic and of causing accidental hepatotoxicity.

1. L. Schmucker and H. Sanchez examined the impaired liver regeneration seen in older people and suggested that the regenerative capacity of aged liver is not impaired, instead the rate of regeneration is decreased which has an huge influence while making the choice for the use of donor livers from older people in liver transplantation.

Another author, A. Warren et al studied an ultrastructural study of the liver in old age, with detailed evaluation of the hepatic stellate cell, a cell causing fibrotic liver changes in disease. The study demonstrated lipid engorgement of the cells with ageing, there is no activation. Moreover, smooth muscle actin expression, the stage of the hepatic stellate cell dedifferentiation into a fibroblast, is not seen in in old age.

1. He et al researched on cancer therapy in the older person and the liver-related changes that affect the efficacy and toxicity of chemotherapy agents. The authors commented that in order to increase treatment efficiency and reducing toxicity in older age group, treatment should be specifically designed according to individuals with their age and comorbidities.

Besides, L. Gan et al evaluated NAFLD in older population. Advanced age is related with disease severity and fibrosis progression. It has been reported that high proportion of individuals with progressive forms of NAFLD when reaches 70 years or beyond, develop cirrhosis. 

Source: Cogger VC, Hilmer SN, Svistounov D. Mechanisms and Implications of Age-Related Changes in the Liver. Current Gerontology and Geriatrics Research. Available at: https://www.hindawi.com/journals/cggr/2011/150364/