- The number of prescriptions taken by seniors doubled from 1988 to 2010, contributing to a higher incidence of functional limitations
- The use of multiple medications increases the risk of adverse events and drug interactions that lead to permanent damage or death
- Side effects from one drug often lead to the prescription of another to reduce symptoms, known as a “prescribing cascade”
- The number of seniors prescribed antidepressants from 1991 to 2011 has more than doubled, while only 14.3% met the DSM-4 criteria for depression; the prevalence of symptoms and disorders has not decreased with more medicine
- A focus on reducing inflammation and seeking the root causes of health conditions helps lower dependence on drugs that usually come with a significant list of side effects
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
Antidepressant Use Has Doubled in Seniors
In a study10 published in 2013, scientists looked at participants who were prescribed antidepressants by their physicians. Of those who were over age 65, only 14.3% met the DSM-4 criteria for having had a major depressive episode — indicating they most likely were overprescribed or not necessary. The authors noted the importance of providing better diagnoses to patients as well as more appropriate treatments of their symptoms.
And again, statistics show more prescriptions don’t translate into fewer depressive illnesses. For example, in a 2017 study,11 researchers reviewed data from 1990 to 2015 that had been gathered in England, Canada, the U.S. and Australia and found the incidence of symptoms had not decreased despite an increase in the number of prescriptions of antidepressants.
This is important because the risks associated with depression in seniors include cognitive decline, dementia and poor medical outcomes. Those suffering from depression in any age group also experience higher rates of suicide and mortality.
This is one reason the American Psychiatric Association writes that in some cases, treatment for the elderly “should parallel that used in younger age groups.”12 Unfortunately, even though therapy for depression can include psychotherapy and alternative treatments, such as addressing vitamin deficiencies, good sleep habits, proper nutrition and exercise, too often, seniors are only prescribed medication — and that only adds to the multiple prescriptions they’re probably already taking.
Studies Link Depression to Inflammation
In related studies, researchers have found that inflammation contributes to many chronic diseases including heart disease and dementia.13 They also have found a link between inflammation and depression. The authors of one literature review14 included results from 30 randomized control trials with a total of 1,610 participants. Data analysis showed anti-inflammatory agents could reduce depressive disorder when compared to a placebo.
Results from another large meta-analysis15 revealed similar findings: Anti-inflammatory medications were helpful for those dealing with depression.
Yet another group of researchers16 found that those treated with immunotherapy for an inflammatory disorder experienced symptomatic relief of depressive symptoms. All of this points toward other ways of addressing depression than resorting to a prescription antidepressant. For a discussion of how to reduce inflammation naturally, see the articles below and consider optimizing your melatonin, adding fiber to your diet and grounding.
Seek Out the Root of the Health Condition
Before adding one more prescription medication or over-the-counter drug to your daily regimen, consider seeking the help of a natural health physician who can help get to the root of the problem. Too often medications mask symptoms but do not address the underlying condition. A vicious cycle may begin when the first medication triggers a side effect that a second medication will be prescribed to treat.
While your pharmacy computer may flag some drug interactions, the chemical complexity involved when more than three drugs are prescribed make it unnecessarily challenging to avoid adverse reactions. The real solution is to take control of your health and introduce foundational strategies to improve your overall health.
There is no magic pill that will fix symptoms, remove your illness and restore the vigor of youth. However, there are lifestyle choices you can make that will go a long way toward achieving your health goals. Consider starting with the strategies in the following articles to move toward better health:
- The Science of Sleep and Sleep Deprivation
- Autophagy — How Your Body Detoxifies and Repairs Itself
- How to Make Fasting Easier, Safer and More Effective
- Incorporate the Nitric Oxide Dump
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