Drugs & Aging最新文献

{"title":"Managing Acute Severe Ulcerative Colitis in the Older Patient: A Growing Concern.","authors":"Walter Fries, Giuseppe Costantino, Anna Viola","doi":"10.1007/s40266-026-01294-w","DOIUrl":"10.1007/s40266-026-01294-w","url":null,"abstract":"<p><p>Since the prevalence of older patients with ulcerative colitis is increasing, hospitalizations for severe disease in this age group are expected to rise. Older patients are more likely to present with comorbidities and, consequently, frailty, the latter being one of the major drivers of worse outcomes. The conventional sequencing of therapies in acute severe ulcerative colitis-i.e., intravenous steroids followed, in case of refractoriness, by antitumor necrosis factor (TNF) agents, ciclosporin A, or Janus kinase inhibitors such as tofacitinib or upadacitinib-may frequently be contraindicated in older patients or may carry an increased risk of severe adverse events beyond infections. In the absence of specific guidelines, the implementation of and strict adherence to a structured, time-bound decision tree is essential in order to avoid unnecessarily prolonged treatment with systemic steroids in frail patients, which may lead to deleterious outcomes, particularly in those requiring surgery. Recent reports on adjunctive measures, such as hyperbaric oxygen therapy or total enteral nutrition, may also be considered given their encouraging safety profile.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"307-311"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Bone Fragility in Older Adults with Diabetes: Pathophysiology, Assessment, and Therapeutic Considerations.","authors":"Gulistan Bahat, Tugba Erdogan, Savas Ozturk, Ozlem Soyluk Selcukbiricik, Serdar Ozkok, Dilek Gogas Yavuz, Mehmet Akif Karan, Jean-Yves Reginster","doi":"10.1007/s40266-026-01290-0","DOIUrl":"10.1007/s40266-026-01290-0","url":null,"abstract":"<p><p>Older adults with diabetes mellitus, encompassing both type 1 diabetes (T1D) and type 2 diabetes (T2D), face a substantially elevated risk of fragility fractures, contributing significantly to morbidity and mortality in this vulnerable population. The underlying pathophysiology differs between the two types: T1D is typically characterized by reduced bone mineral density (BMD) stemming from insulinopenia, whereas T2D often presents with normal or even high BMD but compromised bone quality due to factors, including altered microarchitecture, accumulation of advanced glycation end products (AGEs), and low bone turnover. These distinct mechanisms create challenges for accurate fracture risk assessment, as standard tools such as dual-energy X-ray absorptiometry (DXA)-measured BMD and the Fracture Risk Assessment Tool (FRAX) often underestimate the true risk, particularly in T2D. Effective management necessitates a comprehensive, individualized approach. This includes optimizing glycemic control while minimizing hypoglycemia, implementing lifestyle modifications such as adequate nutrition (calcium, vitamin D, protein) and appropriate exercise, and crucially, proactive fall prevention strategies. Careful consideration must be given to the selection of antidiabetic medications, avoiding agents known to harm bone (e.g., thiazolidinediones) and preferring those with neutral or potentially beneficial skeletal effects (e.g., metformin, dipeptidyl peptidase-4 inhibitors [DPP-4i], glucagon-like peptide-1 receptor agonists [GLP-1 RAs]). Osteoporosis pharmacotherapies, including antiresorptive (bisphosphonates, denosumab) and anabolic agents (teriparatide, abaloparatide, romosozumab), appear effective in patients with diabetes largely on the basis of post hoc analyses and observational data, although evidence specific to this population remains limited. Integrating geriatric principles, such as assessing frailty and polypharmacy, is essential for optimizing care and improving outcomes for older adults with diabetes and bone fragility.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"341-360"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147485050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Anticholinergic Burden and Dry Mouth Severity in Acutely Ill Older Adults.","authors":"Ingrid Beate Ringstad, Eva Skovlund, Leonor Roa Santervas, Hege Kersten, Katrine Gahre Fjeld, Lene Hystad Hove, Torgeir Bruun Wyller, Janicke Liaaen Jensen, Rita Romskaug","doi":"10.1007/s40266-026-01286-w","DOIUrl":"10.1007/s40266-026-01286-w","url":null,"abstract":"<p><strong>Background: </strong>Dry mouth is a common and burdensome condition in older adults and its severity may increase with use of anticholinergic medications. The aims were to describe anticholinergic medication use among acutely ill older adults, examine the association between anticholinergic burden and dry mouth severity using the composite Dry Mouth Severity Points (DMSP) measure and investigate whether the association differs by sex.</p><p><strong>Methods: </strong>Patients ≥70 years admitted to Oslo municipal inpatient acute care unit were eligible. Anticholinergic burden (ACB) was assessed using the ACB calculator and classified as 0, lower (ACB = 1-2) or high (ACB = ≥ 3). Dry mouth severity was quantified with DMSP, range 0-4, assigning one point for each indicator above cut-off: General Xerostomia Question ≥ 3, Summated Xerostomia Inventory ≥ 11, Clinical Oral Dryness Score ≥ 6 and unstimulated whole saliva secretion rate ≤ 0.1 mL/min. Associations were examined with ordinal logistic regression.</p><p><strong>Results: </strong>Of 382 examined patients, 256 (mean age 84 ± 7 years, 70% women) had complete data. Mean [standard deviation (SD)] ACB score was 2.0 (1.7); 18% had ACB = 0, 50% had ACB = 1-2 and 32% had ACB = ≥ 3. DMSP scores of 0, 1, 2 and ≥ 3 were present in 29%, 36%, 23% and 12%, respectively. Compared with patients with ACB = 0, those with ACB = 1-2 [odds ratio (OR) = 2.06, 95% confidence interval (CI) 1.07-3.97) and ACB = ≥ 3 (OR = 2.25, 95% CI 1.09-4.63) had higher odds of more severe dry mouth. Women had significantly higher ACB and DMSP scores than men.</p><p><strong>Conclusions: </strong>Even lower anticholinergic burden was associated with greater dry mouth severity, highlighting the need for early recognition and proactive management in acutely ill older adults.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"361-371"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating Potential Prescribing Cascades Resulting in Prochlorperazine Prescription: An Exploratory Analysis of Antihypertensives and NSAIDs.","authors":"Steven Gilmore, Emma Wallace, Ann Sinéad Doherty","doi":"10.1007/s40266-026-01293-x","DOIUrl":"10.1007/s40266-026-01293-x","url":null,"abstract":"<p><strong>Introduction: </strong>A prescribing cascade occurs when medication is used to treat or prevent an adverse drug reaction (ADR) to another medication. These prescriptions may contribute to problematic polypharmacy in people who are older. Research investigating potential prescribing cascades resulting in prochlorperazine prescription to treat non-steroidal anti-inflammatory drug (NSAID) or antihypertensive-induced dizziness or nausea is limited.</p><p><strong>Aim: </strong>The aim of this study is to explore potential prescribing cascades resulting in prochlorperazine prescription after antihypertensive or NSAID initiation in community-dwelling Irish adults who are older.</p><p><strong>Methods: </strong>Prescription sequence symmetry analysis was conducted on a pharmacy claims database of dispensed medications in Ireland (2017-2020) (n = 514,056). Participants (aged ≥ 65 years) were included if they met General Medical Services Scheme eligibility and were incident users of either exposure medication-(i) antihypertensives (alpha adrenoreceptor blockers, beta blockers, calcium channel blockers, diuretics, angiotensin receptor blockers, angiotensin-converting enzyme inhibitors) or (ii) NSAIDs-and the potential cascade medication, prochlorperazine. The primary observation window was 365 days. Crude and adjusted sequence ratios with 95% confidence intervals (CI) were calculated. Stratified analyses of observation window time, sex and individual medications were conducted.</p><p><strong>Results: </strong>Significant positive associations were identified for antihypertensives and NSAIDs leading to subsequent prochlorperazine prescription. Adjusted sequence ratios (aSR) ranged from 1.27 (95% CI 1.16-1.40) for all diuretics to 1.81 (95% CI 1.49-2.19) for urological alpha adrenoreceptor blockers. The prevalence of each medication dyad ranged from 1.04% for urological alpha adrenoreceptor blockers to 1.38% for cardiac alpha adrenoreceptor blockers. The magnitude of positive associations was slightly attenuated for all dyads when the observation window was reduced to 180 and 60 days, although almost all of these remained significant. Results varied by sex and individual medication. The beta-blocker-to-prochlorperazine dyad had an aSR of 1.94 (95% CI 1.60-2.36) for male patients and 1.45 (95% CI 1.27-1.66) for female patients.</p><p><strong>Conclusions: </strong>NSAID and antihypertensive-induced ADRs such as dizziness or nausea may contribute to subsequent prochlorperazine initiation among adults who are older, representing a potential prescribing cascade. Further research examining data that include clinical indications for prescribing is needed to confirm whether these signals represent true prescribing cascades or prescribing for another reason. ADRs should be included in the differential diagnosis for people who are older presenting with new symptoms in primary care.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"373-383"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Vascular Endothelial Growth Factor Biosimilars for Use in the Aging Eye.","authors":"Ashish Sharma, Jay U Sheth, Baruch D Kuppermann","doi":"10.1007/s40266-026-01292-y","DOIUrl":"10.1007/s40266-026-01292-y","url":null,"abstract":"<p><p>Anti-vascular endothelial growth factor (anti-VEGF) therapies have revolutionized the treatment of neovascular age-related macular degeneration (nAMD), a leading cause of vision loss, in addition to other retinal vascular diseases such as diabetic macular edema (DME), retinal vein occlusions (RVO). Biosimilars, which are nearly identical versions of original biologic drugs, offer a promising alternative to these costly treatments. Several biosimilars for anti-VEGF drugs including bevacizumab, ranibizumab, and aflibercept are in various stages of development and approval (e.g. Afilivu, Yesafili, Enzeevu, Ahzantive, AVT-06, ABP 938, and ALT L9). These biosimilars have shown comparable results in improving visual acuity and reducing retinal fluid in patients with nAMD but their adoption in clinical practice faces challenges, including regulatory hurdles, physician and patient acceptance, and the need for extensive post-marketing surveillance to monitor long-term safety and efficacy. However, as more data becomes available and biosimilars gain approval, they are expected to become an integral component in the management of nAMD. This review explores the current landscape of anti-VEGF biosimilars, their clinical efficacy, safety profiles, and the economic implications for treating the aging eye. It also addresses the challenges and future directions in the integration of biosimilars into routine ophthalmic practice.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"327-339"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and Safety of DOACs in Patients with Atrial Fibrillation and History of Falls or Risk of Falls: The Liverpool AF-Falls Project. A Systematic Review and Bayesian Network Meta-analysis.","authors":"Thibaut Galvain, Ruaraidh Hill, Sarah Donegan, Robert Wilkinson, Gregory Y H Lip, Gabriela Czanner","doi":"10.1007/s40266-025-01272-8","DOIUrl":"10.1007/s40266-025-01272-8","url":null,"abstract":"<p><strong>Purpose: </strong>Non-vitamin K antagonist oral anticoagulants (DOACs) are the preferred treatment over vitamin K antagonists (VKAs) for patients with atrial fibrillation (AF). However, AF patients at risk or with history of falls seldom receive anticoagulants due to the bleeding risk. The objective was to assess the efficacy and safety of DOACs in AF patients with history or risk of falls.</p><p><strong>Methods: </strong>A systematic literature review was conducted until October 31, 2024. Primary outcomes were stroke/systemic embolism (SSE) and major bleeding (MB). Bayesian network meta-analyses were conducted. Hazard ratios (HRs) with 95% credible intervals (CrI) quantified the effect of drugs; cumulative ranking curves (SUCRA) were used to determine their hierarchy.</p><p><strong>Results: </strong>Out of 961 articles, 10 articles (5 randomized controlled trials and 5 observational studies) were retained for quantitative synthesis. Risk of bias was moderate to serious. In reducing the risk of SSE compared with VKAs, apixaban had a SUCRA of 0.87 (HR 0.72, 95% CrI 0.59-0.96), followed by rivaroxaban (HR 0.80; 95% CrI 0.63-0.99; SUCRA 0.68), edoxaban (HR 0.96; 95% CrI 0.48-1.91; SUCRA 0.38) and dabigatran (HR 0.92; 95% CrI 0.68-1.28; SUCRA 0.37). In reducing the risk of MB, compared with VKAs, edoxaban had a SUCRA of 0.86 (HR 0.66; 95% CrI 0.50-0.92) followed by apixaban (HR 0.67; 95% CrI 0.55-0.87; SUCRA 0.83), and dabigatran (HR 0.79; 95% CrI 0.64-1.00; SUCRA 0.54).</p><p><strong>Conclusions: </strong>DOACs appear to have different efficacy and safety profiles and overall are preferable over VKAs in patients with AF with a history or risk of falls. Because of bias, further research is warranted.</p><p><strong>Trial registration: </strong>PROSPERO identifier no. CRD42020201086.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"313-325"},"PeriodicalIF":3.8,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147473047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing the Digital Revolution: How Artificial Intelligence is Transforming Clinical Trials in Older Participants.","authors":"Yaru Wang, Miao Miao, Qingqing Wang, Yuyin Yin, Haijuan Zhao, Shuang Zhao, Han Yang, Xin Wang","doi":"10.1007/s40266-026-01288-8","DOIUrl":"10.1007/s40266-026-01288-8","url":null,"abstract":"<p><p>Artificial intelligence (AI) is revolutionizing clinical trials in geriatric populations by addressing the unique challenges of aging-related diseases and patient heterogeneity. Advanced AI techniques, including machine learning, deep learning, and AI-driven digital health platforms, enable intelligent patient stratification, risk prediction, and real-time monitoring tailored to older adults. AI facilitates the design and execution of decentralized clinical trials, improving accessibility and compliance among older participants. Moreover, AI-powered digital twins and predictive models enhance safety assessments and treatment personalization, optimizing therapeutic outcomes. By integrating multi-omics data, electronic health records, and wearable device outputs, AI enables precise and dynamic decision-making throughout the trial lifecycle. This approach not only increases trial efficiency and accuracy but also supports ethical, patient-centered research practices. This review explores the transformative role of AI in geriatric clinical trials, outlining key advancements, practical challenges, and strategic directions for establishing AI as a catalyst for precision medicine in aging populations.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"239-250"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Multifaceted Pharmacist-Led Intervention on Medication Appropriateness and Medication Burden in Patients Admitted to an Acute Geriatric Ward: Results from the ASPIRE Trial.","authors":"Laura Hellemans, Lotte Blocquiaux, Julie Hias, Karolien Walgraeve, Astrid Liesenborghs, Astrid Lammens, Mieke Deschodt, Jos Tournoy, Lorenz Van der Linden","doi":"10.1007/s40266-026-01278-w","DOIUrl":"10.1007/s40266-026-01278-w","url":null,"abstract":"<p><strong>Background: </strong>Geriatric inpatients are vulnerable to medication-related harm, yet effective interventions remain scarce. The ASPIRE randomized controlled trial evaluated a pharmacist-led intervention aimed at reducing unplanned hospital revisits through comprehensive medication reviews targeting inappropriate pharmacotherapy and polypharmacy.</p><p><strong>Methods: </strong>This study assessed the intervention's impact on medication appropriateness and medication burden at admission, discharge, and 1 month post-discharge in patients admitted to an acute geriatric ward. Medication appropriateness was measured using the Medication Appropriateness Score (MAS), summating STOPP and START criteria version 3, and by tracking reductions in potentially inappropriate medications (PIMs) as measured by STOPP and potential prescribing omissions (PPOs) according to START. Medication burden was assessed through changes in total medication count, polypharmacy (≥ 5 drugs), and excessive polypharmacy (≥ 10 drugs). Univariable and multivariable linear mixed models and generalized estimating equations were applied for continuous and dichotomous outcomes respectively. Data were collected from electronic health records and contact with patients, family members, and healthcare professionals.</p><p><strong>Results: </strong>The trial included 415 intervention and 410 control patients with a mean age of 86.3 (± 5.9) years. Multivariable linear mixed models showed significant improvements in MAS (β = - 0.97 at discharge, β = - 0.93 1 month post-discharge), PIMs (β = -0.85 at both time points) and PPOs (β = - 0.25 at discharge, β = - 0.24 1 month post-discharge) between intervention and control patients (all p < 0.0001). There was no reduction in medication count, polypharmacy, or excessive polypharmacy.</p><p><strong>Conclusions: </strong>The ASPIRE intervention significantly improved medication appropriateness in patients admitted to an acute geriatric ward without reducing overall medication burden, resulting in a shift from inappropriate to appropriate polypharmacy.</p><p><strong>Trial registration number and date of registration: </strong>NCT04617340, 2020-10-29.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"293-306"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146092397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treating Genitourinary Syndrome of Menopause in Postmenopausal Women with a History of Breast Cancer.","authors":"Dewonna Ferguson, Holly Pederson, Juliana M Kling","doi":"10.1007/s40266-026-01287-9","DOIUrl":"10.1007/s40266-026-01287-9","url":null,"abstract":"<p><p>Genitourinary syndrome of menopause (GSM) remains widely underdiagnosed and undertreated. It affects up to 60% of breast cancer survivors, is often worsened by oncologic treatments and can progress with age, all leading to diminishing quality of life, particularly in older women. A stepwise, symptom-driven treatment model is recommended-beginning with non-hormonal options and advancing to local vaginal therapies or ospemifene when appropriate. Treatment decisions should be tailored to cancer subtype, receptor status, prior therapies, and time since diagnosis, while also considering symptom burden and patient preferences. Local estrogen is generally safer in tamoxifen users, but caution is warranted with aromatase inhibitors due to potential systemic absorption. In patients with estrogen receptor-negative disease, local hormone use may be considered but requires careful risk-benefit evaluation and shared decision making is essential. Until long-term safety data emerge, management should remain individualized, evidence-based, and multidisciplinary.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"211-221"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147303568","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Beers Criteria Potentially Inappropriate Medication Use and Associated Factors among Three US Studies.","authors":"Chris M Gillette, Andrea M Anderson, Courtney J Perry, Dave M Reboussin, Pamela L Lutsey, Lynne E Wagenknecht, Michael P Bancks","doi":"10.1007/s40266-026-01280-2","DOIUrl":"10.1007/s40266-026-01280-2","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to assess the prevalence of potentially inappropriate medication (PIM) use among adults ≥ 65 years, overall and for population subgroups, and factors associated with prevalent PIM use.</p><p><strong>Methods: </strong>Participant and medications data from the Atherosclerosis Risk in Communities (ARIC), Multi-ethnic Study of Atherosclerosis (MESA), and Action for Health in Diabetes (Look AHEAD) were used. The total number of individuals contributing to analysis was 9439 for ARIC, 5223 for MESA, and 3771 for Look AHEAD. Participants' medication data were collected at study exams with medication inventories. Prevalence of any PIM use (yes/no), total number of PIMs used, and the major drug classes of PIMs used within a cohort were identified using Beers Criteria closest to the time of study exam (1997 onward) for all participants aged 65 years or older. Multivariable adjusted logistic regression was used to assess demographic and clinical factors associated with prevalence of any Beers Criteria PIM at the first exam after turning 65 years of age, separately for each cohort.</p><p><strong>Results: </strong>The prevalence of PIM use at the first exam at ≥ 65 years was 67% in ARIC, 51% in MESA, and 70% in Look AHEAD. The most prevalently used PIM classes across cohorts were non-aspirin pain medications, proton-pump inhibitors, and sulfonylureas. Higher body mass index and diabetes were consistently associated with greater odds of PIM use across cohorts.</p><p><strong>Conclusions: </strong>Use of potentially inappropriate prescription and nonprescription medications was highly prevalent across three diverse cohorts and highlights the need for clinicians and pharmacists to review patient medication lists and optimize management of medications.</p>","PeriodicalId":11489,"journal":{"name":"Drugs & Aging","volume":" ","pages":"267-275"},"PeriodicalIF":3.8,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12995985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146141075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}