The New York Times1 reports that the average person in their mid- to late 60s today is taking 15 prescription drugs a year — and that doesn’t even count the number of over-the-counter products they may be taking.
That’s a lot of medications, especially when you consider that a survey released by the American Association of Retired Persons (AARP)2 not quite four years ago, in 2016, indicated that 75% of the respondents — all over age 50 — said they take at least one prescription medication on a regular basis.
In that AARP survey, more than 80% reported taking at least two, and more than 50% took four or more. Compared to a 2005 Gallup survey,3 which showed 52% of all Americans said they were taking at least one prescription medication, it’s obvious that seniors are taking more drugs than they did in the past.
Specifically, from 1988 to 2010, adults over age 65 doubled the number of prescriptions they took from two to four.4 The proportion of adults taking five or more tripled in that same time period. Yet, despite the rising number of prescriptions, more drugs don’t add up to better health.
According to the researchers, “Contemporary older adults on multiple medications have worse health status compared to those on fewer medications, and appear to be a vulnerable population.” This translates to a negative effect on activities of everyday living as well as increased confusion and memory problems.
The term used to describe a condition in which a person takes multiple medications, drugs, supplements and over-the-counter remedies is polypharmacy. As evidenced by the quoted research, the clinical relevance and consequences of polypharmacy — of seniors taking fistfuls of medications each day — are far-reaching as the aging population across the world continues to grow.
Polypharmacy Raises Safety Risk
Polypharmacy is common among the elderly, especially for those who reside in nursing homes. Some end up in a nursing home because of adverse drug reactions, which places financial and emotional burdens on communities and families. They also may result in a significant number of hospitalizations with a high number of complications, increased rates of death and excessive health care costs.5
What’s worse, you may believe the federal government, medical associations or pharmaceutical companies have tested the effects that combinations of drug chemicals would have in your body but, unfortunately, this doesn’t always happen.
Researchers report these adverse drug reactions are responsible for up to 12% of all hospital admissions of seniors. Yet, even being in the hospital doesn’t ensure against, or reduce, polypharmacy.
In one study,6 a team in Italy evaluated 1,332 inpatients who were at least 65 years old and who took at least five medications. They found polypharmacy was present in 51.9% of the patients when they arrived at the hospital; this increased to 67% by the time they left.
Taking One Drug to Offset Side Effects of Another Drug
One of the hidden dangers of polypharmacy is the chemical interactions that occur in the body when medications are mixed. Another problem is the number of times one drug is prescribed to take care of the side effects of another. This has become known as a “prescribing cascade.” The New York Times writes:7
“One common example is the use of anti-Parkinson therapy for symptoms caused by antipsychotic drugs, with the anti-Parkinson drugs in turn causing new symptoms like a precipitous drop in blood pressure or delirium that result in yet another prescription.”
To that end, drug interactions can cause hospitalizations in and of themselves — and sometimes these interactions can even lead to death. The authors of one study8 noted a 50% increase in this problem when seniors are taking five to nine medications.
Dr. Michael Stern, geriatric emergency medicine specialist at New York Presbyterian Hospital, told a New York Times reporter that polypharmacy accounts for more than one-fourth of all admissions to the hospital and that it would be considered the fifth leading cause of death if it were categorized that way.9