As individuals age, their bodies undergo natural changes that alter how medications are processed, posing risks that differ from younger adults. The concept of “Beers drugs” highlights specific medications warranting careful consideration in older adults due to potential harms.
Defining the Beers Criteria
The Beers Criteria are a set of guidelines designed to help healthcare professionals identify medications that may be potentially inappropriate for older adults. These criteria are not meant to be a strict prohibition but rather a tool to guide safer prescribing practices. Their purpose is to minimize adverse drug events and improve medication selection for individuals aged 65 and older.
The American Geriatrics Society (AGS) develops and regularly updates these criteria, reflecting the latest scientific evidence. This comprehensive list guides healthcare providers on drugs to avoid, use with caution, or adjust dosages for, helping them make informed decisions based on a patient’s overall health and potential drug interactions.
Why Certain Medications Are Risky for Older Adults
As people age, their bodies experience physiological changes that affect how medications are absorbed, distributed, metabolized, and eliminated. Kidney and liver functions, which are important for clearing drugs from the body, often decline with age. This can lead to medications staying in the system longer, potentially accumulating to toxic levels and increasing the risk of side effects.
Changes in body composition also play a role, with a decrease in muscle mass and an increase in fatty tissue. These shifts can alter how drugs are distributed throughout the body, affecting their concentration and impact. Older adults can also become more sensitive to certain medications, particularly those that act on the central nervous system, making them more susceptible to side effects like dizziness or confusion.
Types of Medications on the Beers List
The Beers Criteria include various medication classes that can pose risks for older adults, often due to specific side effects. For instance, some anticholinergic drugs, frequently found in cold remedies or medications for overactive bladder, can lead to confusion, dry mouth, or constipation. Benzodiazepines, used for anxiety or insomnia, are associated with an increased risk of falls and cognitive impairment because they can cause drowsiness and unsteadiness.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can increase the risk of gastrointestinal bleeding or kidney problems, particularly in older individuals. Certain antipsychotics, while necessary for some conditions, may increase the risk of stroke or cognitive decline in older adults with dementia. The Beers Criteria also highlight medications that may interact negatively with other drugs or exacerbate existing health conditions.
Managing Medications on the Beers List
If a medication an older adult is taking appears on the Beers List, it does not automatically mean it should be stopped. Instead, it signals the need for a careful discussion with a healthcare provider. The criteria serve as a guide, prompting a review of the medication’s necessity, dosage, and potential alternatives. It is important to remember that stopping any medication without medical guidance can be harmful.
Patients and caregivers should openly communicate their concerns and provide a complete list of all medications, including over-the-counter drugs and supplements, to their doctor. Healthcare providers can then assess the individual’s specific health needs, consider potential de-prescribing strategies, or explore safer treatment options. This collaborative approach ensures that medication regimens are optimized for safety and effectiveness in older adults.