Seniors: beware of incompatible medicines

The use of medicines becomes almost inevitable and regular from the age of sixty. As a consequence of this phenomenon, seniors aged 65 currently take an average of 3.6 drugs daily and this figure rises to 4.6 for people aged 85.
Poly-drug use is a source of iatrogeny, i.e. the interaction of several associated drugs or their incompatibility or a mistake in taking them. In the over-65s, iatrogenia is responsible for 10 to 20% of hospital admissions. To raise awareness of this risk among health professionals and the public, drug manufacturers have launched a major information campaign on the subject. The situation is truly alarming: according to a study carried out by the French National Health Insurance, half of the population over 75 years old has inappropriate prescriptions. The problem concerns benzodiazepines in particular. One third of people over 65 and almost 40% of those over 85 use them regularly as sleeping pills. More than half of these treatments are not appropriate: true insomnia is rare in the elderly. Moreover, benzodiazepines are known to cause falls and accelerate the onset of dementia. These drugs are emblematic, but they are not the only ones that can be dangerous. Many should be used with caution because of the decline in kidney function with age. The kidneys eliminate two out of three of them, but with age, elimination is less efficient and the drugs will accumulate in the tissues and blood. This is why a drug prescribed for a chronic illness to a 50-year-old will become toxic a few years later. One must also be vigilant during an influenza episode which will lead to dehydration. The renal function will then suddenly deteriorate and the drug, which was previously well tolerated, will become toxic for the senior citizen or elderly person. Another risk factor is the accumulation of illnesses that appear over the years, such as diabetes, hypertension, osteoarthritis, chronic bronchitis, etc. Consulting several specialist doctors will dangerously lengthen the list of medicines and multiply the risk of interactions between the different molecules. For this reason, elderly people should absolutely avoid self-medication without the advice of their doctor or pharmacist. The risk-benefit ratio of each prescribed drug must be assessed individually.