Older adults who take five or more prescription medications daily are at a significantly higher risk of death compared to those taking fewer drugs, a study published in the Journal of the American Geriatrics Society has found. The research addresses the growing concern surrounding polypharmacy, the medical term for using five or more daily prescriptions, and its long-term impacts on aging populations.
Researchers led by Dr. Alexander Chaitoff of the University of Michigan School of Medicine analyzed national survey data from 7,828 adults aged 65 and older collected between 1999 and 2016. Trained staff verified medication use by inspecting participants' pill bottles over the preceding 30 days. The participants were then followed for an average of 8.5 years.
More than half of the participants, 54.3%, fell into at least one high-risk medication category. The largest subgroup, over 40% of the study's participants, were taking five or more prescription medications. Additionally, 37.6% used medications identified as risky for older individuals due to their potential to increase the risk of confusion or falls, and 11.4% took combinations of medications known to cause major drug-to-drug interactions.
After adjusting for overall health and underlying conditions, taking five or more prescriptions was associated with a 38% increase in the overall risk of mortality. The study also found that each additional prescription medication added to a patient's regimen was linked to a 7% increase in the risk of death.
The total number of medications a participant took emerged as the strongest independent predictor of mortality, even when accounting for drug-to-drug interactions and potentially inappropriate prescriptions. Medical experts at the Cleveland Clinic note that taking multiple medications can increase the likelihood of side effects, adverse drug reactions, and accidental overdose, especially as the liver and kidneys become less efficient at processing drugs with age.
These findings could help clinicians identify patients who may benefit from safely stopping or reducing unnecessary medications, a process known as "deprescribing." However, the study's authors noted certain limitations. The research focused exclusively on community-dwelling older adults, excluding those in nursing homes or assisted care facilities. Furthermore, medication use was documented through a single 30-day snapshot at the study's commencement, preventing researchers from tracking subsequent prescription changes or evolving health conditions over time. Experts also emphasize that observational studies like this demonstrate an association rather than direct causation; older adults taking higher numbers of prescriptions often have multiple severe or complex health conditions that independently carry a higher mortality risk.