Polypharmacy Rises Among Seniors, but Major Drug Interactions Decline
A cross-sectional study of U.S. adults aged 62 and older found that prescription and supplement polypharmacy increased between 2015-2016 and 2021-2023, while the proportion experiencing potentially major drug-drug interactions fell from 25.7% to 22.3%. Antidepressants remained the most common source of major interactions, and regimens involving muscle relaxants rose significantly. The authors urge deprescribing efforts to prioritize these persistent interacting combinations.
The study drew on two waves of the National Social Life, Health, and Aging Project, comparing roughly 2,754 adults in 2015-2016 with 2,186 in 2021-2023. While prescription and supplement use held steady, concurrent use of five or more of each climbed. Over-the-counter medication use actually declined during the period.
Potentially major interactions fell from 25.7% to 22.3%, yet antidepressants still topped the list of interaction sources. Muscle relaxant regimens rose from 1.35% to 2.49%, which researchers linked to possible overdose concerns. The authors called for deprescribing efforts to target these persistent combinations.
This trend could affect millions of older Americans and their caregivers, as polypharmacy raises risks of hospitalizations and adverse events. The persistent role of antidepressants and rising muscle relaxant use may signal shifting prescribing patterns that warrant closer attention. While the decline in major interactions offers some reassurance, the remaining one-in-five rate suggests deprescribing initiatives could meaningfully reduce harm, though implementation challenges remain.