More than one in five older Americans take medication combinations carrying risks of major drug interactions, while polypharmacy rates climb, according to a study published in JAMA. Researchers tracking adults aged 62 to 85 found that simultaneous use of five or more prescription drugs and dietary supplements continues to present major public health challenges.
Navigating complex medical regimens gets harder with age, and new national data reveals just how widespread the issue has become. Researchers evaluated information from the National Social Life, Health and Aging Project—which receives backing from the National Institute on Aging—within a study published in JAMA to monitor supplement and prescription patterns among U.S. adults aged 62 to 85. Researchers compared records from 2015–2016 with data from 2021–2023, documenting a clear upward trajectory in the sheer volume of products older patients ingest daily.
Polypharmacy, defined as taking five or more prescription medications at the same time, climbed from 31 percent to 35.7 percent across the study periods. Dietary supplement polypharmacy saw a parallel rise, jumping from 12.6 percent to 16.7 percent. Dr. Spencer Kroll, a physician with expertise in pharmacology, pointed to that overall growth as one of the work’s most critical findings.
“Patients who have several chronic illnesses are inevitably treated with complicated regimens,” Dr. Spencer Kroll, a physician with expertise in pharmacology, told Newsweek. “It is encouraging to see that the number of people exposed to potentially serious drug-drug interactions is down.”
Dr. Spencer Kroll, physician with expertise in pharmacology
Yet Kroll emphasized that improvement should not overshadow the remaining danger. He told Newsweek that exposure rates hovering above one-fifth of the elderly population remain a major public health challenge, particularly in geriatric care.
Drug Interaction Risks Involving Antidepressants, Statins, and Antiplatelet Therapies
Though the prevalence of potentially major drug-drug interactions declined from 25.7 percent to 22.3 percent during the study period, more than one in 5 older adults remained at risk between 2021 and 2023. The investigation—spearheaded by Dima Mazen Qato from the USC Schaeffer Center for Health Policy and Economics alongside the USC Mann School of Pharmacy and Pharmaceutical Sciences—revealed that the specific classes of medication driving these high-risk combinations remained virtually unchanged over time.
Antidepressants, statins, and antiplatelet therapies appeared most frequently in high-risk combinations. Because these categories are widely prescribed to manage cardiovascular and mental health, patients cannot simply avoid them.
“These are essential medicines for managing the health of the cardiovascular system and the mental health in older populations, so we can’t avoid them. But it also requires the greatest caution because interactions between these drug classes can lead to severe complications, such as increased bleeding and reduced metabolism.”
Dr. Spencer Kroll, physician with expertise in pharmacology, via Newsweek
When metabolism slows down due to conflicting compounds, the likelihood of toxicity and patient harm increases, even when every individual pill is prescribed properly to improve health outcomes.
Cognitive Decline and the Central Nervous System Risk Factors
For older adults living with cognitive disorders like dementia, the risks tied to central nervous system medications require specialized scrutiny. Researchers at the University at Buffalo examined data from 2,796 older adults with cognitive disorders living independently, publishing their findings on August 4 in the Journal of the American Geriatrics Society. Their analysis tracked exposure to inappropriate drugs that act on the central nervous system to treat conditions such as anxiety, sleep problems, and psychosis.
The study found that exposure to these potentially inappropriate medications dropped from 39.3 percent in 2011 to 29.3 percent in 2022. While the drop represents an encouraging shift across an 11-year window, roughly one-third of the target population remains exposed to drugs that can worsen memory or thinking.
“This is a population with some mental issues that relate to the central nervous system. These drugs also act on the central nervous system, so they can be too much for older adults if inappropriately used.”
Haowen Hsu, postdoctoral fellow in the Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences at the University at Buffalo
The study derived its baseline from the American Geriatric Society’s Beers Criteria, a catalog of roughly 100 medications considered potentially harmful to older adults. Investigators narrowed their focus to diagnose specific vulnerabilities in patients who already struggle with cognition.
Managing Complex Regimens Through Deprescribing and Coordinated Care
Unmanaged medication combinations frequently trigger emergency department visits, extended hospitalizations, deteriorating mental health, and heightened mortality risks. Researchers emphasize that proactive clinical strategies can reverse these outcomes.
Patients who have relied on benzodiazepines like Xanax for anxiety or sleep aids like Ambien for years often require dosage reductions or careful tapering. University at Buffalo researchers point to deprescribing—removing unnecessary drugs, lowering frequencies, or switching to milder alternatives—as a central tool for protecting aging patients.
“These findings underscore the need for continuing efforts to improve medication safety among older adults. Efforts to reduce polypharmacy and harmful drug interactions should focus on commonly used interacting regimens, particularly those involving antidepressants.”
Dima Mazen Qato, USC Mann School of Pharmacy and Pharmaceutical Sciences and USC Schaeffer Center for Health Policy and Economics, via Newsweek
Systemic hurdles compound the problem. Kroll noted that fragmented care across multiple physicians, isolated pharmacies, and disconnected hospital networks often prevents comprehensive medication reviews. Electronic medical record systems frequently fail to communicate across different clinical practices, leaving patients to manage compounding pharmacological complexities without a centralized safety net.
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