To the Editor:As many as 13% of the United States population are 65 years of age or older.1 This population is expected to double by 2030. Although elderly patients account for only 13% of the population, they consume about 30% of prescription medications and 40% of over-the-counter medications.1 It is becoming increasingly important for health care providers to be cognizant of the special precautions that must be taken into consideration with the use of medications in the elderly population.1 This population is viewed as generally being at risk for the development of the adverse effects related to medications. These effects can be attributed to a myriad of age-related characteristics, illnesses, or disease states. Some of the most widely identified issues include the reduction of organ function (eg, liver or kidney function), fragility, and co-occurring disease progression.2 Advanced age is also commonly associated with the development of multiple illnesses and altered pharmacokinetics and phar-macodynamics as they relate to medications. For example, there is delayed renal elimination of drugs or increased sensitivity to medication classes such as anticholingerics, hypnotics, or sedatives in elderly patients.3 For this particularly sensitive population, careful consideration must be given to age-related renal decline. Proper evaluations should be routinely performed to assess the risks versus benefits of initiation and/or continuation of specific medications classes based on organ function and the patient's ability to tolerate a medication. This assessment process can also help to optimize care or lead to the discontinuation of medications when deemed appropriate to curtail polypharmacy. Keeping a medication on a patient's medication profile longer than it should be prescribed has the potential to cause more harm than good in the elderly population.
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