The liver undergoes numerous changes with ageing that influences the clinical characteristics and outcomes in patients with liver diseases. Both liver volume and blood flow are known to decrease significantly with age. These changes along with decreased cytochrome P450 activity affects drug metabolism, thus increasing susceptibility to drug-induced liver injury. 

Some of the changes in the clinical characteristics are described below-

• Viral hepatitis like Hepatitis A is associated with higher hospitalization and mortality rates, Hepatitis B is more likely to progress to chronic hepatitis or cirrhosis, while Hepatitis C is more likely to progress fibrosis, have higher rates of hepatocellular carcinoma development and demonstrated a decreased tolerability to treatment in the elderly.
• Autoimmune diseases like autoimmune hepatitis may sometimes be progressive, primary biliary cirrhosis possesses higher rates of treatment-related complications, sometimes be progressive and more likely to have osteoporosis in the elderly.
• Alcoholic liver disease is progressive, Nonalcoholic fatty liver disease has a higher prevalence and is progressive, while hepatocellular carcinoma has higher rates of development in the discussed population.

Tajiri K, Shimizu Y. Liver physiology and liver diseases in the elderly. World J Gastroenterol. 2013;19(46):8459-8467. doi:10.3748/wjg.v19.i46.8459