December 1986

Drug Prescribing for the Elderly

Author Affiliations

From the Division on Aging, Harvard Medical School (Drs Everitt and Avorn), and the Joint Department of Medicine, Beth Israel Hospital and Brigham and Womens Hospital and the Geriatric Research, Educational, and Clinical Center, West Roxbury/Brockton Veterans Administration Medical Center, Boston (Dr Everitt); and Department of Social Medicine and Health Policy, and the Program for the Analysis of Clinical Strategies, Harvard Medical School, Boston (Dr Avorn).

Arch Intern Med. 1986;146(12):2393-2396. doi:10.1001/archinte.1986.00360240133022

The elderly are especially sensitive to both the intended pharmacologic effects of drugs and their undesirable adverse reactions. Twenty-five percent of all prescription drugs are taken by those over 65 years of age although this group comprises less than 12% of the population. The average older person fills more than twice as many prescriptions as those under age 65. Polypharmacy, variable compliance, and multiple pathology, combined with altered physiologic response, make the elderly especially prone to adverse drug reactions. One study has shown that the elderly women sampled took an average of 5.7 prescription drugs and 3.2 over-the-counter drugs concurrently.1 The incidence of adverse effects clearly increases with age and with the number of drugs taken,2,3 and elderly residents of nursing homes are particularly vulnerable to the toxicity of inadequately monitored drug regimens.4

Multiple illnesses are common in the elderly and contribute to a higher incidence of

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