The Case Against Too Many Drugs and Aging

Abstract: Researchers with the Duke University School of Medicine recently embarked on a study to determine whether or not taking multiple medications can be associated with how strong, mobile, and steady an individual feels even before the setting in of old age occurs. study looked at data from nearly 2,000 adults, average age 60, and found that nearly one in three were taking five or more medications – a threshold considered polypharmacy. 

When Prescriptions Add Up

Whether it’s a blood pressure pill, something for cholesterol, or a medication to help you sleep, it’s easy to accumulate prescriptions over time, especially during midlife, say researchers with the Duke University School of Medicine.

With that in mind, they recently embarked on a study to determine whether or not taking multiple medications can be associated with how strong, mobile, and steady an individual feels even before the setting in of old age occurs.

A release from the university, states that “researchers using the long-running CARDIA study looked at data from nearly 2,000 adults, average age 60, and found that nearly 1 in 3 were taking five or more medications – a threshold considered polypharmacy. Those taking five or more prescriptions walked slower, had weaker grip strength, and showed worse balance than peers on fewer medications.”

Lead study author Caroline Sloan internist at Duke Health and expert in population health sciences, says that “what this tells us is that physical decline related to medication use may not be just a problem for people in their 70s or 80s,” said. “It could start showing up in your 50s or early 60s, when people still expect to be independent and mobile.”

The CARDIA Study and Why It Matters

CARDIA is the acronym for the Coronary Artery Risk Development in Young Adults, a project that started in 1983, that according to the National Heart, Lung and Blood Institute (NHLBI) based in Bethesda, Md. has two primary goals: Examine the factors that contribute to the development of cardiovascular disease as well as to better understand the natural history of cardiovascular disease over the entire adult life.

Long-term studies like the CARDIA study are critical to uncovering the root causes of cardiovascular disease beginning early in life. Over the last 35 years, findings from the CARDIA study have contributed greatly to our knowledge about the importance of lifestyle and environmental factors in the development of cardiovascular disease later in life.

The Impact of Polypharmacy in Midlife

One of the key conclusions: There’s strong evidence that taking five or more medications can worsen physical function and increase the risk of falls in older adults, partly due to drug interactions or overlapping health conditions. However, few studies have looked at these effects in middle age.

Sloan worked with Duke Health geriatrician and chronic disease expert Dr. Christopher Barrett Bowling on the study, which was published this summer in the Journal of General Internal Medicine.

According to the release, researchers measured physical function using five standardized tests — including grip strength, gait speed, and a six-minute walk — and combined the results into a single score called the CARDIA Physical Performance (CAPP) score.

Those taking five or more medications scored, on average, 1.24 points lower on the 20-point CAPP scale than those not taking multiple medications — a gap that reflects a real and meaningful difference.

Results from an additional part of the study suggest that it’s not necessarily the type of drug that matters, but the sheer number.

“If I’m seeing a 58-year-old on 15 medications, that should prompt me to think about their physical function,” said Sloan. “They may benefit from a physical therapy referral or an exercise program and more broadly, it’s an opportunity to take a closer look at their medication list.”