A recent study highlights significant challenges faced by older adults discharged from hospitals while taking multiple medications. Conducted in Japan and published in the journal BMC Geriatrics on December 17, 2023, the research suggests that polypharmacy—defined as the use of six or more regular medications—can hinder the recovery of older patients during rehabilitation.
The study analyzed data from 1,903 patients aged 65 and older who received rehabilitation at a convalescent hospital in Japan from April 2017 to March 2024. Researchers focused on patients suffering from one of three conditions: cerebrovascular disease, motor disorders, or disuse syndrome. Notably, more than 62.1% of these patients were taking six or more medications upon discharge, with over 76% of them aged 80 or older.
Those involved in the study who were on multiple medications were more likely to be prescribed benzodiazepine receptor agonists, which are commonly used for anxiety and insomnia, as well as laxatives and psychotropic medications aimed at treating various mood disorders. The researchers found that older adults with polypharmacy, particularly those with cerebrovascular disease and disuse syndrome, scored significantly lower on the Functional Independence Measure (FIM) compared to those who were not on multiple medications.
This measure assesses an individual’s ability to perform everyday activities independently, particularly after illness or hospitalization. Interestingly, patients with motor disorders did not show a similar correlation between polypharmacy and FIM scores. The adverse effects of multiple medications were particularly pronounced among patients aged over 80 and those recovering from stroke-related conditions or general weakness due to inactivity.
Dr. Marc Siegel, a senior medical analyst at Fox News, described polypharmacy in seniors as a “risky proposition.” He emphasized that while each medication may serve a purpose, the ability to tolerate and metabolize drugs diminishes with age. “A medication that sedates or disorients may have a more pronounced effect as one ages,” he noted.
The study’s findings suggest that reviewing and reducing unnecessary medications could enhance recovery for older adults undergoing rehabilitation. Dr. Siegel pointed out that the risk of drug interactions increases as patients age, necessitating careful monitoring by healthcare providers. He advocates for a cautious approach, stating, “Sometimes, less is more.”
Despite the significant insights gained from this research, the authors acknowledge several limitations. The retrospective observational design of the study does not establish a direct causative relationship between medication use and rehabilitation outcomes. Additionally, the study lacked detailed information on specific medication dosages and the intensity of rehabilitation received by patients. Given that the research was conducted at a single hospital, the results may not be generalizable to broader populations.
Future studies are encouraged to identify which specific medications most significantly affect recovery and to develop optimal strategies for reducing prescriptions in older adults. As the population ages, understanding the implications of polypharmacy will be crucial in improving health outcomes for seniors.
