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16 HE ALTH • Spring 2020 Seniors across Massachusetts and America are being overmedicated, as movement grows in the health industry to de-prescribe patients • By Grant Welker W hen old age comes and aches and pains and other ailments pop up, seniors have a seemingly unending list of prescription drugs to turn to. For a number of doctors who've studied the issue, that may be exactly the problem. Studies are showing seniors are much more likely to take a prescription drug – and even to take five or more. That's raised alarms over seniors taking too many drugs, leading to more common cases of adverse side effects or even what's known as the prescribing cascade, when one drug needs to be prescribed just to address a side effect of another drug. Doctors can struggle to find the balance, and they don't always handle the complexity well, said Dr. Gary Blanchard, a geriatrician at Saint Vincent Hospital in Worcester. "At times, it's an impossible balance," Blanchard said. "Sometimes the right thing is to watch things and not introduce things that may be harmful." With an aging population combined with the potential negative effects of taking multiple medications, further study is needed to find the right balance, a 2015 National Institutes of Health-funded report said. More than 1 million Massachusetts residents are 65 or older, according to a 2017 U.S. Census Bureau estimate. That's about 14% of the population, and a 13% rise in a five-year period. The Lown Institute, a Brookline nonprofit, called over-prescribing of seniors an epidemic in a report last April. Over the last decade, those 65 and older have been hospitalized for serious drug side effects about 2 million times, the group said. "The bottom line is, they know how to prescribe … They don't know how to de-prescribe," said Shannon Brownlee, the Lown Institute's senior vice president, addressing the issue of having a patient wean off a drug. A spike in prescribing Seniors have long had higher rates of taking multiple medications, but in the past decade or more, usage has spiked. In 1999 and 2000, 84% of seniors said they took a medication, according to a 2015 study in the Journal of the American Medical Association. By 2011 and '12, it was 90%. Those taking five or more pre- scriptions rose even more during that time: from 24% to 39%. Among men over age 80, half reported taking five or more medications by 2010, rising nearly fivefold since 1988, a 2015 study in the Journals of Gerontology found. If trends continue, according to the Dr. Gary Blanchard, Saint Vincent Hospital Too many prescriptions