Older adults taking five or more prescription drugs face higher risk of death

Navigating medication routines in later life carries mounting complications, as aging bodies process drugs less efficiently. Food and Drug Administration. These physiological shifts make older adults significantly more vulnerable to adverse events.

Polypharmacy Risks and Mortality Findings in Older Adults

A study published in the Journal of the American Geriatrics Society evaluated national survey data collected from 7,828 adults aged 65 and older between 1999 and 2016, according to reporting from Fox News. Led by Dr. Alexander Chaitoff of the University of Michigan School of Medicine, researchers had trained staff directly inspect participants’ pill bottles to verify medication use over a 30-day window before following patients for an average of 8.5 years.

The analysis revealed that more than half of participants, or 54.3%, fell into at least one high-risk medication category. Over 40% of the older adults studied were engaging in polypharmacy—defined as taking five or more prescription medications daily. After adjusting for overall health and underlying conditions, taking five or more prescriptions was associated with a 38% increase in overall mortality risk, with each additional prescription adding a 7% increase in death risk.

“People taking more medications often have more underlying health conditions, which may also contribute to their higher mortality risk.”

Katy Dubinsky, New York-based pharmacist and founder of PostGigs

In addition to polypharmacy, 37.6% of those studied used medications deemed risky for older individuals—such as drugs capable of increasing confusion or falls—while 11.4% took combinations known to cause major drug-to-drug interactions. Experts at the Cleveland Clinic noted that taking multiple medications raises the likelihood of adverse drug reactions and accidental overdoses, particularly as renal and hepatic clearance slows down.

Persistent Overuse of Benzodiazepines and Antibiotics

Beyond broad polypharmacy, specific drug classes widely prescribed to older Americans continue to face scrutiny over overuse and entrenched clinical habits. Deprescribing Research Network, as reported by KFF Health News.

Benzodiazepines prescribed for anxiety and insomnia, along with related Z-drugs, impair balance, cognition, and coordination, which frequently leads to falls, fractures, and motor vehicle accidents, according to Mark Olfson, a psychiatrist and epidemiologist at Columbia University. When combined with opioids for pain, these drugs can cause fatal overdoses. Although prescription filling rates among adults 65 and older dropped to 11.5% in 2024 from roughly 14% in 2015, that decline stalled around 2020. Among adults over 75, prescribed use actually climbed from 12% in 2020 to about 13% four years later, while long-term care facility dispensing more than doubled.

Antibiotic overuse for uncomplicated diverticulitis presents similar challenges. Although the American Gastroenterological Association recommended against routine antibiotic use for uncomplicated cases starting in 2015, entrenched prescribing practices persist. Jesse Sutton, a pharmacist and researcher at the Minneapolis Veterans Affairs healthcare system, noted that historical reliance on antibiotics meant clinicians turned to them automatically, despite clinical trials showing they provided little or no effect on mortality, surgical needs, or recurrence rates while elevating risks for severe side effects and C. difficile infections.

Deprescribing Strategies and Clinical Recommendations

Researchers and clinical experts emphasize that observational findings highlight associations rather than direct causation, meaning patients should never discontinue medications independently. I would not recommend that anyone stop a medication because of this study, Dubinsky cautioned, advising patients to review their complete regimen with a physician or pharmacist, including over-the-counter drugs, vitamins, and supplements.

Supervised tapering is particularly crucial for drugs like benzodiazepines, where abrupt cessation triggers withdrawal symptoms. Clinicians can utilize these study findings to identify patients who are strong candidates for deprescribing—the practice of carefully reducing or stopping unnecessary medications when risks outweigh clinical benefits.