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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One of the Little known Causes of Headaches

Posted August 15, 2017 by Dr. Steve Chaney

Your Sleeping Position May Be Causing Your Headaches!

Author: Julie Donnelly, LMT – The Pain Relief Expert

Editor: Dr. Steve Chaney

 

Can sleeping position be one of the causes of headaches?  

A Sleeping position that has your head tilted puts pressure on your spinal cord and will cause headaches. I’ve seen it happen hundreds of times, and the reasoning is so logical it’s easy to understand.

causes of headachesYour spinal cord runs from your brain, through each of your vertebrae, down your arms and legs. Nerves pass out of the vertebrae and go to every cell in your body, including each of your organs. When you are sleeping it is important to keep your head, neck, and spine in a horizontal plane so you aren’t straining the muscles that insert into your vertebrae.

The graphic above is a close-up of your skull and the cervical (neck) vertebrae. Your nerves are shown in yellow, and your artery is shown in red.  Consider what happens if you hold your head to one side for hours. You can notice that the nerves and artery will likely be press upon. Also, since your spinal cord comes down the inside of the vertebrae, it will also be impinged.

In 2004 the Archives of Internal Medicine published an article stating that 1 out of 13 people have morning headaches. It’s interesting to note that the article never mentions the spinal cord being impinged by the vertebrae. That’s a major oversight!

Muscles merge into tendons, and the tendons insert into the bone.  As you stayed in the tilted position for hours, the muscles actually shortened to the new length.  Then you try to turn over, but the short muscles are holding your cervical vertebrae tightly, and they can’t lengthen.

The weight of your head pulls on the vertebrae, putting even more pressure on your spinal cord and nerves.  Plus, the tight muscles are pulling on the bones, causing pain on the bone.

Your Pillow is Involved in Your Sleeping Position and the Causes of  Headaches

sleep left side

The analogy I always use is; just as pulling your hair hurts your scalp, the muscle pulling on the tendons hurts the bone where it inserts.  In this case it is your neck muscles putting a strain on your cervical bones.  For example, if you sleep on your left side and your pillow is too thick, your head will be tilted up toward the ceiling. This position tightens the muscles on the right side of your neck.

sleeping in car and desk

Dozing off while sitting in a car waiting for someone to arrive, or while working for hours at your desk can also horizontal line sleepcause headaches. The pictures above show a strain on the neck when you fall asleep without any support on your neck. Both of these people will wake up with a headache, and with stiffness in their neck.

The best sleeping position to prevent headaches is to have your pillow adjusted so your head, neck, and spine are in a horizontal line. Play with your pillows, putting two thin pillows into one case if necessary. If your pillow is too thick try to open up a corner and pull out some of the stuffing.

 

sleeping on stomachSleeping on Your Back & Stomach

If you sleep on your back and have your head on the mattress, your spine is straight. All you need is a little neck pillow for support, and a pillow under your knees.

Stomach sleeping is the worst sleeping position for not only headaches, but so many other aches and pains. It’s a tough habit to break, but it can be done. This sleeping position deserves its own blog, which I will do in the future.

 

Treating the Muscles That Cause Headaches

sleeping position causes of headachesAll of the muscles that originate or insert into your cervical vertebrae, and many that insert into your shoulder and upper back, need to be treated.  The treatments are all taught in Treat Yourself to Pain Free Living, in the neck and shoulder chapters.  Here is one treatment that will help you get relief.

Take either a tennis ball or the Perfect Ball (which really is Perfect because it has a solid center and soft outside) and press into your shoulder as shown.  You are treating a muscle called Levator Scapulae which pulls your cervical vertebrae out of alignment when it is tight.

Hold the press for about 30 seconds, release, and then press again.

Your pillow is a key to neck pain and headaches caused by your sleeping position.  It’s worth the time and energy to investigate how you sleep and correct your pillow.  I believe this blog will help you find the solution and will insure you have restful sleep each night.

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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