More Than 1 in 5 Older Americans Still Face a Hidden Medication Risk
More than one in five older Americans are still taking combinations of medications and supplements that could trigger major drug interactions, even as the prevalence of those risky regimens has edged downward in recent years, according to a new study in JAMA.
The findings, drawn from nationally representative data on nearly 5,000 U.S. adults ages 62 to 85, arrive as older Americans increasingly use multiple prescription drugs and dietary supplements at the same time. Researchers and independent experts say that pattern is fueling persistent concerns about medication safety, side effects and preventable hospitalizations in an aging population.
“Patients who have several chronic illnesses are inevitably treated with complicated regimens,” Dr. Spencer Kroll, a physician with expertise in pharmacology, told Newsweek. “It is encouraging to see that the number of people exposed to potentially serious drug-drug interactions is down.”
But, he added, “the number exposed remains well over one-fifth of the elderly. This persistence is a major public health challenge, especially in geriatric care.”
The issue is particularly consequential in geriatric care, where patients often live with multiple chronic conditions and receive prescriptions from different clinicians. Each added medication can alter how another is absorbed, metabolized or cleared, raising the odds of side effects and hospital admissions.
Newsweek contacted the study authors by email for additional comment.
The study, led by Dima Mazen Qato of the USC Mann School of Pharmacy and Pharmaceutical Sciences and the USC Schaeffer Center for Health Policy and Economics, analyzed data from the National Social Life, Health and Aging Project, which is supported by the National Institute on Aging.
Researchers compared medication and supplement use among older adults in 2015-2016 with use in 2021-2023. They found that polypharmacy—defined as taking five or more prescription medications at once—rose from 31 percent to 35.7 percent. Dietary supplement polypharmacy increased from 12.6 percent to 16.7 percent.
Medical supplies on a bedside table.
Kroll said the rise in overall medication use was among the study’s most important findings.
“The data show a significant growth in the simultaneous use of five or more prescribed medicines and dietary preparations,” he told Newsweek. “From a pharmacological point of view, this is alarming because each additional chemical entity increases the pharmacokinetic and pharmacodynamic complexity of the aging body.”
As regimens become more complex, he added, so do the risks—including side effects and unplanned hospitalizations.
“With each added medication for a patient, the consequences of drug-drug interactions increases exponentially,” Kroll said.
Although the prevalence of potentially major drug-drug interactions declined from 25.7 percent to 22.3 percent during the study period, researchers noted that more than one in five older adults remained at risk in 2021-2023.
The medication classes most often involved in potentially major interactions changed little over time. Antidepressants, statins and antiplatelet therapies were the most commonly used medications appearing in high-risk combinations.
Kroll said that finding is especially significant because all three categories are widely used and often medically necessary.
“These are essential medicines for managing the health of the cardiovascular system and the mental health in older populations, so we can’t avoid them,” he said. “But it also requires the greatest caution because interactions between these drug classes can lead to severe complications, such as increased bleeding and reduced metabolism.”
Reduced metabolism can raise the likelihood of toxicity and patient harm, even when medications are prescribed appropriately to improve health outcomes, he added.
In a statement accompanying the study, Qato said: “These findings underscore the need for continuing efforts to improve medication safety among older adults. Efforts to reduce polypharmacy and harmful drug interactions should focus on commonly used interacting regimens, particularly those involving antidepressants.”
Kroll also pointed to broader challenges in the health care system, including fragmented care across multiple physicians, pharmacies and hospital networks. Older patients often do not receive a comprehensive review of every medication they take, he said, while electronic medical record systems frequently fail to communicate with one another.
“As the population grows older, our patients’ health and independence will depend increasingly on the ability to negotiate these complex interactions in a safe and sensible manner,” he said, describing the findings as a call for physicians to rethink how medications are prescribed and managed in older adults.
Qato, D.M., Wilder J., Ondanat Veetil S.K., et al. (2026). Polypharmacy and Drug-Drug Interactions Among Older Adults. JAMA. doi: 10.1001/jama.2026.17268.
Contact Newsweek editors on this story: Kara Dolman and Shakeema Edwards.
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