According to a new study published in JAMA (The Journal of the American Medical Association), the majority of older adults in the United States regularly use prescription and over-the-counter medications, as well as dietary supplements. The study found that by 2021–2023, the prevalence of so-called polypharmacy — the concurrent use of five or more medications — had increased, affecting more than one-third of people aged 62 to 85 who used prescription medications. Polypharmacy and the concurrent use of multiple medications significantly increase the risk of drug-drug interactions, which, in turn, are associated with preventable adverse events and, in some cases, even fatal outcomes.
Researchers compared data from 2015–2016 and 2021–2023 and found that although the overall use of prescription medications (84%) and dietary supplements (approximately 66%) remained unchanged, the use of over-the-counter medications declined from 60.1% to 55.1%. Although the overall prevalence of concurrent use of medications with potential interaction risks decreased, data from 2021–2023 showed that one in five older adults remained at risk of serious and potentially dangerous drug interactions.
Of particular concern is the fact that the most common groups of medications involved in potentially risky combinations among older adults were antidepressants (7.21%), statins (5.23%), and antiplatelet agents (4.47%). The authors emphasize the risks associated with the concurrent use of antidepressants, as it may increase the likelihood of serotonin syndrome and serious cardiovascular complications, including arrhythmias. Accordingly, experts urge the medical community to exercise particular caution when managing depression in older adults.
A positive trend was the decline in the use of combinations involving opioids and benzodiazepines that carry a risk of drug interactions. At the same time, however, the use of muscle relaxants increased. The authors suggest that combinations involving muscle relaxants may contribute to the rise in fatal cases among older adults caused by accidental medication overdoses. In conclusion, the researchers note that healthcare initiatives aimed at reducing harm caused by polypharmacy and drug interactions — including deprescribing, the practice of discontinuing unnecessary medications — should focus specifically on the medication combinations most widely used among older adults.
