Too many meds in old age? Cutting back could be safe | India News

NEW DELHI: For many elderly people, a typical day starts with a handful of pills – for blood pressure, diabetes, cholesterol and heart disease. But a new global review suggests that in very frail older adults, it may not always be necessary to continue all long-term medications — and in many cases, it may be safe to stop some of them carefully.The findings, published in the journal ‘BMC Geriatrics’, came from an analysis of patients with advanced frailty, dementia or a limited life expectancy – a group often prescribed multiple drugs despite unclear long-term benefits. Researchers have found that reducing or stopping such drugs in most cases does not increase death or major complications.To prevent problems after many years of these drugs. But for frail or critically ill patients, those benefits may never be realized. In turn, taking multiple medications can increase the risk of dizziness, weakness, confusion, and falls, which often lead to hospitalization.Doctors say this pattern of “polypharmacy,” where patients take several medications at once, is increasingly common among the elderly in India. “They often see multiple specialists and prescriptions are not always reviewed together. Overtreatment in the frail elderly can do more harm than good – for example, aspirin should be avoided for primary prevention, too much can cause a fall in blood pressure control, and drugs such as diuretics, insulin or sulfonylureas can cause electrolyte imbalances or hypoglycaemia.” Dr Pulin Gupta, professor of medicine at Ram Manohar Lohia Hospital, said the focus should be on reducing medications where the risks outweigh the benefits.“In frail elderly patients, discontinuing certain preventive medications is generally safe if done carefully, although caution is needed in those who have had a previous heart attack or stroke,” said Dr Romel Tiku, director of internal medicine at Max Hospital, Saket. Commonly overused medications include statins for primary prevention, tightly controlled diabetes medications such as insulin or sulfonylureas, multiple blood pressure medications, sleeping pills, long-term acid suppressants and anticholinergics, he added.“Establishment should be based on goals of care – based on care, frailty and life expectancy – with caution and monitoring,” he said, noting that reducing medication often leads to fewer falls, better cognition and improved energy levels.Families often assume that more medication means better care, but the opposite may be true. Each added drug interaction increases the risk. The review reflects a shift from aggressive prevention to patient-centered care, where treatment is aligned with health and priorities. Experts caution that drugs should not be discontinued arbitrarily; Tapering must be supervised, with each medication reviewed for need.