The Contradictions of Medications

The United States is a heavily-medicated nation. According to the Centers For Disease Control (CDC):

“In 2021, 64.8% of adults aged ≥18 years took prescription medication at any time during the past 12 months. The percentage of adults taking prescription medication was lower among men than women overall (58.4% versus 70.9%) and for those aged 18–44 years (38.9% versus 57.8%) and 45–64 years (67.1% versus 75.7%). Among adults aged ≥65 years, men (89.0%) and women (89.3%) were equally likely to take prescription medication. Prescription medication use increased with age, from 48.4% for those aged 18–44 years to 89.2% for those aged ≥65 years, and this pattern of increasing use with age was observed for both men and women.”

Many people are on multiple medications. I routinely see people come to my assisted living homes on 20-30 medications.

Yet the health of people in the United States is declining.

• Life expectancy is decreasing

• Chronic diseases such as heart disease, liver disease, and diabetes are on the rise

• Drug overdose deaths are increasing, particularly with opioids

• Mental health problems such as depression, loneliness and stress are increasing

A lot of people say that the prescription drugs people are taking are not very effective in solving the problem.

My experience in assisted living makes me have another viewpoint. I am wondering if a lot of these medications are actually contributing to a lot of the health problems we see.

Consider this. I asked ChatGPT for a list of prescription drugs that studies have shown to increase your risk of dementia:

• Anticholinergic medications (examples are antihistamines such as Benadryl). Studies have shown up to a 50% increased risk of dementia

• Benzodiazepines for anxiety or sleep. Think of Xanax, Ativan or Valium. Long-term use, particularly in older adults, has been linked to dementia

• Non-Benzodiazepine (Z-drugs) sleep aids such as Ambient or Lunesta. Memory of fall risk issues.

• Antipsychotics such as Seroquel and Risperidone. May worsen cognitive function and increase mortality in older adults with dementia

• Proton Pump Inhibitors (PPI’s) like Prilosec and Protonix. Risk of dementia with long-term use. It’s debatable according to Chat GPT.

• Statins. I was surprised ChatGPT included them. It does say this is controversial. Seems like if your brain is pretty much made of cholesterol, you wouldn’t want to a drug to lower the amount if you have cognitive issues. But that’s just me.

Yet according to Chat GPT here is the rate of prescription for each of these drugs for people over age 65 in the United States:

• Benzodiazepines and Z-drugs - 8.7% as of 2008 (I couldn’t find more recent data, probably more now)

• Anticholinergic medications - 37-63%. 23.3% of ‘community-dwelling’ individuals with dementia had prescriptions for strong anticholinergics. 27% of dementia patients used inappropriate anticholinergic medications

• Proton Pump Inhibitors - 30.3% of Medicare beneficiaries  over aged 65

• Statins - Atorvastatin is the most widespread drug used for people over 65 in the United States

About 10% of the US population over age 65 has dementia.

I see these kind of drugs prescribed to new residents moving into our homes all the time. And I try to talk to their doctors about deprescribing a lot of them. In many cases we see people’s health improve when they stop taking a medication.

Of course this is not medical advice. You should talk to your doctor before changing any medications. But if you’re feeling lousy or have some kind of issue, maybe it’s worth having that discussion with your doctor. What exactly are those medications doing to you?