Older adults taking five or more prescription medications face a 38 percent higher overall mortality risk, according to a study published in the Journal of the American Geriatrics Society. This widespread practice, known as polypharmacy, is compounded by prescribing chains where drug side effects are misdiagnosed as new medical conditions.
As the human body ages, its internal processing systems slow down, changing how drugs are absorbed, broken down, and cleared from the system.
The Hidden Dangers of Polypharmacy and the 38 Percent Mortality Risk
Researchers analyzing national survey data collected from 7,828 adults aged 65 and older between 1999 and 2016 found that taking five or more daily prescriptions carries profound health consequences (according to a study published in the Journal of the American Geriatrics Society). Trained staff directly inspected participant pill bottles to verify what people were taking over a 30-day window, then tracked outcomes for an average of 8.5 years.
The findings revealed that polypharmacy was widespread. More than half of the participants—54.3 percent—fell into at least one high-risk medication category. Over 40 percent took five or more prescription drugs daily, while 37.6 percent used medications deemed risky for older individuals because they increase confusion or the likelihood of falls. Furthermore, 11.4 percent took specific combinations known to trigger major drug-to-drug interactions.
After adjusting for overall health and underlying conditions, taking five or more prescriptions was associated with a 38 percent increase in overall mortality risk, with each additional medication adding a 7 percent bump to that 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, via Fox News
Prescribing Cascades: When a Side Effect Becomes a New Diagnosis
In a study published in the BMJ examining prescription data from older adults in Ontario, Canada, researchers tracked 24 common drug combinations that emerge from what medicine calls a prescribing cascade.
Lead author Paula Rochon explained the mechanism behind the phenomenon, noting that it happens when a drug side effect is misinterpreted as a new condition, and then a second drug is started to manage the adverse event.
Dr. Rochon serves as director of research at the Weston and O’Born Centre for Mature Women’s Health at Sinai Health in Toronto.
Persistent Overuse of High-Risk Drug Classes
Beyond general polypharmacy and prescription chains, certain drug categories continue to present documented risks for older populations despite years of safety warnings. Benzodiazepines, prescribed widely for anxiety and insomnia, are a prime example.
While prescribing rates for adults 65 and older dropped from roughly 14 percent in 2015 to 11.5 percent in 2024, that downward trend has stalled since 2020 (as reported in an Annals of Internal Medicine examination). Among patients over 75, use actually rose. Psychiatrist and epidemiologist Mark Olfson of Columbia University noted that these drugs may impair balance, coordination, and cognition that can translate into falls and fractures and motor vehicle accidents.
Clinical inertia means older prescribing habits die hard.
“Medications are like barnacles,” said Michael Steinman, a geriatrician at the University of California-San Francisco and co-director of the U.S. Deprescribing Research Network. “They’re easy to start, but they can be hard to stop.”
Michael Steinman, geriatrician at the University of California-San Francisco and co-director of the U.S. Deprescribing Research Network, via KFF Health News
Navigating Deprescribing and Patient Reviews
Federal regulators also advise that medication safety requires strict adherence to proper storage, avoiding extreme temperatures that degrade active ingredients, and checking expiration dates regularly. For patients grappling with complex medication schedules, consulting a pharmacist or health care professional remains the safest path to ensuring appropriate dosing and minimizing avoidable drug interactions.
