Older adults who take five or more prescription medications face a significantly higher risk of death compared to those taking fewer drugs, according to a study published in the Journal of the American Geriatrics Society.
The research highlights the growing concern over polypharmacy, the medical term for taking five or more daily prescriptions, and its long-term effects on aging populations.
Led by Dr. Alexander Chaitoff of the University of Michigan School of Medicine, researchers analyzed national survey data collected from 7,828 adults aged 65 and older between 1999 and 2016.
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Trained staff directly inspected participants’ pill bottles to verify medication use over the previous 30 days, then followed them for an average of 8.5 years, according to a press release.
More than half of participants (54.3%) fell into at least one high-risk medication category. The largest group consisted of older adults taking five or more prescription drugs (polypharmacy).
Another group, 37.6% of those studied, used medications deemed risky for older individuals, such as drugs that can increase the risk of confusion or falls, the study revealed.
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Additionally, 11.4% took combinations of medications that are known to cause major drug-to-drug interactions.
After accounting for overall health and underlying conditions, taking five or more prescriptions was associated with a 38% increase in overall mortality risk. Each additional prescription medication added to a patient’s routine was linked to a 7% increase in death risk.
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Taking multiple medications has been shown to increase the likelihood of side effects, adverse drug reactions and accidental overdose, particularly as the liver and kidneys age and process drugs less efficiently, according to medical experts at Cleveland Clinic.
The total number of medications participants took was the strongest independent predictor of mortality, even after accounting for drug-to-drug interactions and potentially inappropriate prescriptions.
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These findings could help doctors determine which patients are the best candidates for “deprescribing,” or carefully reducing or stopping unnecessary medications, the researchers stated.
The authors noted several limitations, including that the study focused strictly on community-dwelling older adults, excluding those living in nursing homes or assisted care facilities.
Additionally, medication use was documented during a single 30-day snapshot at the start of the study, meaning researchers could not track subsequent changes in prescriptions or evolving health conditions over time.
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Experts emphasized that observational studies show association rather than direct causation. Older adults taking higher numbers of prescriptions often suffer from multiple severe or complex health conditions, which independently carry a higher mortality risk.