TOPLINE

More than one third of older adults took five or more prescription medicines in the past month, and this pattern was associated with a 38% increased risk for death.

METHODOLOGY

• Researchers analyzed data from a US cross-sectional survey (1999-2016) to assess whether usage patterns of higher-risk medications were linked to mortality risk in older adults.
• They included data of 7828 respondents aged 65 years or older (median age, 72 years; 55% women). Staff reviewed pill bottles and recorded medications taken in the past 30 days.
• Three patterns were defined: polypharmacy as taking five or more prescriptions; drug-drug interactions as taking two drugs with a known major interaction; and potentially inappropriate medications as taking a drug considered risky or with anticholinergic effects.
• The primary outcome was death, assessed over a mean follow-up duration of 8.5 years.

TAKEAWAY

• In all, 54.3% of participants had at least one high-risk use pattern: 40.0% had polypharmacy, 11.4% used drugs with interactions, and 37.6% used potentially inappropriate medications.
• Polypharmacy was associated with a 38% increased risk for mortality in a fully adjusted model (P < .01). The association held true for participants aged 65-74 years as well as those aged 75 years or older.
• In a sensitivity analysis, each additional medication was linked to a 7% increased risk for mortality.

IN PRACTICE

“[The] estimates…may provide guidance about which types of patients would be ideal targets for trials studying medication de-escalation,” the researchers wrote.

SOURCE

This study was led by Alexander Chaitoff, MD, MPH, of University of Michigan School of Medicine in Ann Arbor, Michigan. It was published online on July 8 in the Journal of the American Geriatrics Society.

LIMITATIONS

This study was limited to community-dwelling older adults. They recorded the use of medicines for the past 30 days and could not track later changes in medications or health.

DISCLOSURES

This study received support from the Department of Veterans Affairs and Health Systems Research Service. Three authors reported receiving support from these organizations. One author reported receiving a fellowship from the Swiss National Science Foundation, and another reported receiving a grant from the National Institutes of Health. The lead author reported serving as consultant for Alosa Health and AristaMD.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.