Study Reveals How Multiple Medications Affect Recovery in Older Adults
Recent research from Japan has shed light on a critical issue affecting older adults’ recovery after hospitalization: polypharmacy, or the use of six or more regular medications. The study, published in December 2023 in the journal BMC Geriatrics, examined nearly 2,000 elderly patients undergoing rehabilitation and found that those taking multiple medications faced greater challenges in regaining their independence. This finding comes at a crucial time when medication management for seniors is increasingly recognized as a complex healthcare challenge that balances necessary treatment with potential risks. The research focuses particularly on how these medication regimens impact rehabilitation outcomes for different conditions, highlighting the importance of thoughtful prescription practices for our aging population.
The researchers conducted a retrospective observational study involving 1,903 patients aged 65 and older who underwent rehabilitation at a Japanese convalescent hospital over a seven-year period. All patients were recovering from one of three conditions: cerebrovascular disease (affecting blood vessels in the brain), motor disorders (affecting movement and muscle control), or disuse syndrome (physical decline due to inactivity). What’s particularly striking is that more than 62% of these patients were taking six or more medications at hospital discharge, with the vast majority (over 76%) being 80 years or older. The study revealed that certain medication types were particularly common among those with polypharmacy, including benzodiazepine receptor agonists for anxiety or insomnia, laxatives, and various psychotropic medications used to treat mood disorders, depression, and anxiety.
The impact of polypharmacy wasn’t uniform across all patients but showed concerning patterns for specific groups. Using the Functional Independence Measure (FIM), which evaluates a person’s ability to perform everyday activities independently, the researchers discovered that patients with cerebrovascular disease and disuse syndrome who were taking multiple medications scored significantly lower. This suggests these patients experienced greater difficulty in regaining their independence during rehabilitation. Interestingly, patients in the motor disorder group didn’t demonstrate the same relationship between multiple medications and reduced independence. The negative effects appeared most pronounced among the oldest patients (those over 80) and individuals recovering from stroke-related conditions or weakness due to prolonged inactivity—precisely the populations that often need the most successful rehabilitation outcomes to maintain quality of life.
Medical experts have responded to these findings with concern but not surprise. Dr. Marc Siegel, a Fox News senior medical analyst, described polypharmacy in seniors as a “risky proposition,” explaining that while each medication may serve an important purpose, older adults’ ability to tolerate and efficiently metabolize medications diminishes with age. This creates a challenging situation where medications intended to help may actually hinder recovery by causing sedation, disorientation, or other adverse effects that younger patients might not experience. The risk of drug interactions also increases with age, further complicating the medication management picture. Dr. Siegel emphasized that careful monitoring by physicians is essential, suggesting that sometimes “less is more” when it comes to medication regimens for elderly patients, particularly during critical recovery periods when physical and cognitive function need to be optimized.
While the study provides valuable insights into how multiple medications might affect rehabilitation outcomes, the researchers acknowledge several important limitations to their work. Because the study was retrospective and observational in design, it cannot definitively establish that the medications caused poorer outcomes—only that there was an association between the two. Additionally, the researchers lacked specific data on medication dosages and the intensity of rehabilitation programs, both factors that could significantly influence recovery. Another limitation is that the study was conducted at just a single hospital in Japan, potentially limiting how broadly the findings can be applied to more diverse populations or different healthcare systems. Despite these limitations, the research raises important questions about medication management for older adults during recovery and rehabilitation.
Looking forward, the study points to several areas requiring further investigation to improve care for older adults. The researchers suggest that reviewing and potentially reducing unnecessary medications could help improve recovery outcomes for patients undergoing rehabilitation, particularly those with cerebrovascular disease or disuse syndrome. Future research should focus on identifying which specific medications most significantly impact recovery and exploring optimal approaches for medication reduction without compromising necessary treatment. This balanced approach recognizes that while medications are often essential for managing chronic conditions in older adults, their cumulative effects may sometimes work against rehabilitation goals. As our global population ages, finding this balance becomes increasingly important for healthcare systems worldwide, potentially improving not just individual patient outcomes but also efficiency and effectiveness of rehabilitation services. The findings serve as a reminder that medication regimens should be regularly reassessed, especially during transitions of care and rehabilitation periods, with the goal of supporting—rather than hindering—recovery and independence.
