Are Seniors Taking Too Many Medications?

Written by Dr. Steve Chaney on . Posted in Medications

The Dangers of Polypharmacy

Author: Dr. Stephen Chaney

 

seniors taking too much medicationModern medicines are truly miraculous. They control the  symptoms associated with many major diseases. At their best they  save lives. But have we become too reliant on medications to cure  everything that ails us?

Every medication has side effects, and many medications interact  with each other in harmful ways. That has become a major concern for our senior citizens because many of them end up on 5 or more medications, something the  medical profession refers to as polypharmacy.

Why Are Seniors Taking So Many Medications?

It starts innocently enough:

  • antioxidant aging Your cholesterol edges up a bit, and your physician recommends  that you go on a statin to reduce your risk of a heart attack. This  is in spite of the fact that it has been almost impossible to prove  that statins actually decrease heart attack risk in people who  have not yet had a heart attack (See “Do Statins Really Work?”  (https://healthtipsfromtheprofessor.com/cholesterol‐lowering‐ drugs‐right/) and “Does An Apple A Day Keep Statins Away?”  (https://healthtipsfromtheprofessor.com/apple‐day‐keep‐statins‐ away/))
  •  Sometimes your cholesterol may not even be elevated. In today’s world statins are often recommended if you are over a certain  age, are overweight, and have some other risk factor such as pre‐ diabetes or high blood pressure.
  •  Your blood pressure starts to inch up (something that happens to most people as they get  older), and your physician recommends one or two blood pressure medications.
  •  Your blood sugar gets a bit high, and your physician recommends a drug to control your  blood sugar to prevent your pre‐diabetes from turning into diabetes.
  •  Perhaps you develop a minor arrhythmia (something else that often happens as we get  older), and your physician recommends one drug to control your heart’s rhythm and  another drug to thin your blood.

Before you know it you are on several medications. As if that weren’t bad enough, each of these  medications has side effects, so you often need to add other medications to control the side effects  of the original medications. For example:

  •  Perhaps you develop heartburn, gas, and/or bloating from the statin, so your physician recommends a drug to control those side effects.
  •  Perhaps you develop headaches, depression, or g.i. symptoms from your blood pressure medication, and your physician gives you one or more drugs to control those symptoms.

I could go on, but I think you get the point. It is easy for senior citizens to end up on multiple  medications. The question is whether that is a good thing or a bad thing.

Are Seniors Taking Too Many Medications?

are supplements dangerousA recent study (Qato et al, JAMA Internal Medicine,  doi:10.1001/jamainternmed.2015.8581, published online March 21, 2016) shows just how big a problem this has  become. The authors conducted a longitudinal, nationally  representative sampling of community‐dwelling adults  aged 62 to 85 years old. They conducted in‐home  interviews that included medication inspections with  2351 participants in 2005‐2006 and again with another  2206 participants 5 years later in 2010‐2011.  The results were startling:

  •  Simultaneous use of at least 5 prescription medications increased from 30.6% in 2005‐ 2006 to 35.8% in 2010‐2011.   That is a 17% increase in just 5 years!
  •  The percentage of adults using medication combinations with the potential for major drug‐ drug interactions increased from 8.4% in 2005‐2006 to 15.1% in 2010‐2011.   That’s almost double in just the last 5 years! To put that into perspective, it means that almost 1 out of every 6 seniors in this  country is at risk of major drug‐drug interactions.
  •  Most of those dangerous interactions were due to physician prescribed medications,  although interactions with over the counter medications also contributed to the total.

The authors of the study concluded “These findings suggest that unsafe use of multiple  medications is a growing public health problem.”

The Most Dangerous Drug­-Drug Interactions

The problem is that these drug‐drug interactions aren’t minor  inconveniences. They can kill you. Here are some of the more  dangerous drug‐drug interactions the authors listed:  Let’s start with those drug‐drug interactions for physician‐ prescribed medication.

  •  Statins used in combination with some blood pressure  medications or with Coumadin can lead to excessive  bleeding, muscle damage and kidney failure.
  •  The combination of those same blood pressure medications with anti‐platelet blood  thinning medications like Plavix dramatically increases the risk of a heart attack and death.

DangerAnd, it’s not just interactions of physician‐prescribed drugs that are of concern. Interactions  between physician‐prescribed drugs and over the counter medications can be equally dangerous.

These interactions are particularly insidious because patients often don’t tell their doctors about  over the counter medications they are using. For example:

  •  The combination of blood thinners with pain relievers such as aspirin or Aleve generally  leads to excessive bleeding.
  •  However, the combination of certain anti‐platelet blood thinning medications such as  Plavix and either pain medications like Aleve or acid reflux medications like Prilosec can  have the opposite effect – causing blot clot formation (such as deep vein thrombosis)  which can lead to heart attacks and cardiovascular death.

Is There a Better Way?

age-related muscle lossIn an editorial that accompanied this study (JAMA Internal  Medicine, doi:10.1001/jamainternalmedicine.2015.8597)  Dr. Michael A, Steinman said “There are many older adults  who would be healthier if they threw away half of their  medications. Yet, there are people with multiple chronic  diseases who can benefit from multidrug therapy…We  [currently] do not have methods that allow us to reliably  evaluate medication therapy…for the outcomes that really  matter, namely whether a drug is actually helping the  patient, causing adverse effects, or is necessary at all.”

If your doctor doesn’t really know for sure whether the medications you are taking help you, hurt you, or have no effect, you might be wondering whether  there is a better way. The answer is a clear YES!

  •  Multiple studies have shown that lifestyle change is more effective than medications for  keeping blood pressure under control (for example: Guzman‐Castillo et al, BMJ Open,  doi:10.1136/bmjopen‐2014‐006070).
  •  Studies have also shown that lifestyle change is more effective than medications for  controlling diabetes (for example: Knowler et al, New England Journal of Medicine, 346:  393‐403, 2002).
  •  The evidence for heart disease is so strong that both the National Institutes of Health and  the American Heart Association recommend that a little TLC (Therapeutic Lifestyle  Change) be tried before resorting to statins and other medications to lower cholesterol and reduce heart attack risk (http://www.nhlbi.nih.gov/health/resources/heart/cholesterol‐ tlc).

Fortunately, you don’t need different lifestyle changes for different diseases. One size fits all!  I  have talked about a healthy lifestyle in great detail in past issues of “Health Tips From the  Professor.”  In brief, a healthy lifestyle consists of a  mostly plant‐based diet with healthy fats, healthy carbohydrates, and healthy proteins. Then add  in exercise, weight control, and appropriate supplementation and you have a winning  combination.

Why risk the dangers of multiple medications when there is a better way?

The Bottom Line

  1.  A recent study has clearly demonstrated that the use of multiple medications in senior  citizens aged 62 and older is starting to reach dangerous levels. Between 2005 and 2010:
    •  The percentage of seniors using 5 or more medications has increased from 30.6% to  35.8%. That’s a 17% increase in just 5 years.
    •  The percentage of seniors using medication combinations with the potential for  major drug‐drug interactions has increased from 8.4% to 15.1%. That’s almost  double and represents 1 out of every 6 senior citizens.
  2. These dangerous drug interactions aren’t trivial. They include excessive bleeding, heart  attack and stroke, renal failure and death, just to name a few.
  3.  There is a better way. Studies have shown that lifestyle change is more effective than  medication at controlling many chronic diseases such as heart disease, high blood pressure,  and diabetes. Lifestyle change has no side effects and no dangerous interactions. More  importantly, you don’t need different lifestyle changes for different diseases. One size fits  all! I have talked about a healthy lifestyle in great detail in past issues of “Health Tips From  the Professor” (https://healthtipsfromtheprofessor.com). In brief, a healthy lifestyle  consists of:
    •  A mostly plant based diet that includes healthy fats, healthy carbohydrates, and  healthy proteins.
    •  Exercise, weight control, and appropriate supplementation.
  4.  So if you or someone you love are taking multiple medications, talk with your doctor about  the lifestyle changes that you are willing to make. Most doctors would be delighted to  reduce the medications you are taking if you are willing to do your part.

 

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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Latest Article

How to Choose the Right Pillow

Posted April 17, 2018 by Dr. Steve Chaney

Wake Up Each Morning Pain Free

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

how to choose the right pillow without headachesThe way you sleep is often a key to discovering the cause of headaches and more. If you wake up with neck pain, a headache, or you suffer from ringing in your ears, dizziness, or ear pain, there is a good possibility that it may be caused by the way you are sleeping. Your pillow may be the culprit.  But if you need to know how to choose the right pillow for you, it’s easy.   It just takes a little “investigation.”

 

How to Choose the Right Pillow if You Sleep On Your Side

Your head, neck, and spine need to always stay in a nice straight line, just as it is when you are standing up, but that takes a little thought and understanding of the way you sleep.  So, get comfy in your bed and then notice how your head is resting.

how to choose the right pillow to sleep painfreeIf you sleep on your side, your pillow needs to be just the right size, so your head doesn’t point down toward the mattress (your pillow is too soft) or up to the ceiling (your pillow is too thick). Either of these positions will make the muscles on the side of your neck stay in the contracted position for hours and pull your vertebrae in that direction, especially when you try to turn over to your other side.

Your SCM Muscle May Cause Serious Problems

You also need to notice if you turn your head a bit, especially if you are turning into your pillow or turning your head up toward away from your pillow. In either of these two cases you will be causing your sternocleidomastoid (SCM for short) to be held shortened for hours.

Your SCM originates on your collarbone and inserts into the bone behind your ear.  When it contracts you turn your head to the opposite side. However, if the muscle is tight (for example, when you’ve held your head turned toward one side for an extended period of time) and then you bring your head back so you are facing forward, the tight muscle will pull on the bone behind your ear and cause havoc.

The symptoms for a tight SCM are tinnitus (ringing in the ear), dizziness, loss of equilibrium, ear pain, headaches, pain in the eye and around the skull, pain at the top of the head, and even pain in the throat. Amazing! What’s even more amazing is that it’s rare that this muscle is considered when a medical professional is searching for the cause of your symptoms.

These are the things to know when considering how to choose the right pillow if you sleep on your side.

How To Choose The Right Pillow If You Sleep On Your Back

how to choose the right pillow for sleeping on your backIf you sleep on your back, your head should be on the mattress (not propped up with a pillow) and you should have a tiny support (like a folded washcloth) under your neck.  Or, you can have a wedge pillow that starts at your mid-back and gently raises your entire trunk and head up while still allowing your head and back to be in a straight line.

It’s always a challenge for people who toss and turn during the night, sometimes on their side and sometimes on their back.  The best thing I’ve found for this situation is to have the pillow below shoulder level so when you turn on your side your shoulder will automatically slide to the edge of the pillow while still supporting your head properly, and when you turn onto your back, the pillow will start at shoulder level so your head and neck are supported, but your head is being pushed in a way that causes your chin to move down to your chest.

hip pain causes and treatment pain freeIt’s tricky, but I can personally attest to the fact that it will work.  I can always tell when I’ve had my head tilted (I toss and turn during the night) because I will wake with a headache. When that happens I’m grateful that I know how to self-treat the muscles of my neck and shoulders so the headache is eliminated quickly.  If you already have Treat Yourself to Pain Free Living,  you can self-treat all your neck and shoulder muscles to release the tension.

How To Choose The Right Pillow If You Sleep On Your Stomach

If you sleep on your stomach, this is the one position that is so bad that it behooves you to force yourself to change your position. Your head is turned to the side and held still for hours, putting a severe strain on all your cervical and upper thoracic vertebrae. Not only will this cause headaches, tinnitus, and a list of other pains, but it can cause problems down your entire spine. It can also impinge on the nerves that pass through the vertebrae on their way to your organs.

If you do sleep that way, let me know and I’ll give you some suggestions that work to change your habit of sleeping. It takes time and energy, but the results are worth the effort.

In every case, the way you sleep may cause neck pain that won’t go away until the pillow situation is resolved.

Now you should know how to choose the right pillow for the way you sleep.

Wishing you well,

Julie Donnelly

About The Author

julie donnelly

Julie Donnelly is a Deep Muscle Massage Therapist with 20 years of experience specializing in the treatment of chronic joint pain and sports injuries. She has worked extensively with elite athletes and patients who have been unsuccessful at finding relief through the more conventional therapies.

She has been widely published, both on – and off – line, in magazines, newsletters, and newspapers around the country. She is also often chosen to speak at national conventions, medical schools, and health facilities nationwide.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

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