Talking to Your Doctor About Polypharmacy and Deprescribing

Why do older adults take so many meds?

It’s not uncommon for adults to accumulate medications as they age. Chronic conditions, such as arthritis, high blood pressure and diabetes, become increasingly common as we age, and medications can help manage these issues. According to the Centers for Disease Control and Prevention, the most commonly used medications among U.S. adults in their 60s and 70s are for high cholesterol, high blood pressure and diabetes.

Another reason: When people have multiple health problems, they’re more likely to see more than one doctor — they may have a cardiologist to manage their heart disease and a rheumatologist for arthritis in addition to their primary care physician. “Before we know it, there are a lot of cooks in the kitchen adding a bunch of different medications,” Little says. 

There’s also what Little calls “the prescribing cascade,” where a doctor might prescribe a medication to treat a health issue, and that medication causes a side effect. “So then we prescribe a medicine or they go and get something over the counter to address that issue,” Little says, and the medications keep piling on.

The availability of options adds to the problem, Takhar says. According to the Food and Drug Administration, more than 20,000 prescription drugs are approved for use in the U.S. “It feels like patients have a likelihood of being on a lot more medications today because there’s so much more available than in the past. And so we just need to be really cautious that we’re using them in an effective way,” she says.

How can older adults avoid polypharmacy?

Deprescribing is something to consider if you’re taking multiple medications and experiencing new symptoms, such as dizziness, falls or confusion — or if you develop a new illness or feel that a particular medication may no longer be helping, says Dr. Juliessa Pavon, associate professor of medicine and senior fellow in the Center for the Study of Aging and Human Development at the Duke University School of Medicine.  

First, make a detailed list of all of the medications you take, including any drugs that have been prescribed during a hospital or skilled nursing stay, as well as any over-the-counter meds and vitamins and supplements you take.

“A good starting point is simply asking, ‘Do I still need all of these medications?’ and reviewing the risks, benefits, and personal goals of each medication together with a clinician,” Pavon says.

You may also want to see if any of the medications on your list are also on the American Geriatrics Society Beers Criteria (last updated in 2023), which lists medications that may pose extra risks for older adults because of their side effects. It is important to understand that not all medications included on the list are unsafe for all patients. This list should be used to identify potentially higher risk medications and initiate conversations with your primary care doctor about your individual benefits and risks.

If you feel like you don’t have time to fully review your medications during your routine check in with your doctor, you can set up a special “medication review visit,” which is covered under Medicare Part D for many older adults.

If your doctor recommends going off a medication or reducing your dosage, be sure you know what to expect. Will any symptoms reemerge, or will side effects pop up? If so, how will you manage them? 

And know that not all medicines can just be stopped, Takhar says. “Sometimes we have to taper off slowly or monitor certain things.”

Experts emphasize that medication reviews shouldn’t be a one-time conversation; it’s important to make them a regular part of your care.

“Preventing polypharmacy starts with regularly reviewing medications and remembering that adding a medication should never be a one-way decision; every medication should periodically be reassessed to make sure it still fits a person’s health goals and needs,” Pavon says. “The goal isn’t fewer medications at all costs. The goal is the right medications for the right person at the right time. As our health changes, our medication lists should evolve too.” 

How tech can reduce polypharmacy

Technology is being enlisted to combat polypharmacy and encourage deprescribing via prompts from electronic medical records. These prompts are used to encourage doctors to deprescribe and share the risks of potentially inappropriate medications with their patients. One recent study published in the Journal of the American Medical Association found these types of prompts made doctors more likely to deprescribe at least one medication for their patients.

Polypharmacy and mental well-being

In addition to the physical risks, research from AARP finds that taking multiple medications may affect the mental well-being of older adults. Results from a survey of adults age 40-plus, published in June 2025, found that over half (55 percent) of those taking five or more medications reported low mental well-being, compared to 46 percent of those who take fewer than five medications.

Similarly, 47 percent of adults 40-plus taking five or more medications had low life satisfaction, compared to 37 percent of those who take four or fewer medications.

“Those with multiple medical conditions are more likely to experience polypharmacy, as well as medical side effects and unpleasant drug interactions — realities that can have detrimental impacts in the form of social isolation, life satisfaction and mental well-being,” the researchers write.

“The connection that emerges from still-limited research once again underscores the importance of increasing healthy habits (both physical and mental) to delay the onset of medical conditions and associated use of prescription medications.”