Is It Dementia or Drugs?
Various forms of dementia, including Alzheimer’s, are a real possibility as we age. But one possibility that often isn’t considered when older people begin to exhibit memory problems is known as polypharmacy, which literally means “many drugs.”
Our family practice doctors at Cohen Medical Associates in Delray Beach carefully monitor the different medications our patients take to guard against interactions and side effects. But we can’t monitor those we aren’t aware of. It’s critical that we know about all the drugs you’ve been prescribed because polypharmacy can have serious—even deadly—results.
Drug interactions and side effects can affect people of any age, but they are particularly worrisome in older adults who may attribute many of their distressing symptoms to “old age,” thus, they may be less likely to complain. Family members and caretakers may also tend to ascribe such symptoms to the normal aging process.
Many drugs, many effects
Yet experts have found that not only signs of dementia but many other disabilities associated with aging may sometimes be attributed to polypharmacy.
These can include:
- cognitive impairment
- urinary incontinence
- internal bleeding
- vision problems
Again, drug interactions can occur with any prescription or over-the-counter medication or supplement at any age, especially if people are suffering from chronic conditions. But seniors tend to be more susceptible to the negative effects of polypharmacy for several reasons.
First, as people age, they don’t metabolize medications as well as they did when they were younger. This can lead to a build-up of drugs in their system that might cause side effects now that they didn’t experience five or ten or 15 years earlier.
Second, aging brings more health conditions that spur more prescriptions. For example, we might prescribe certain medications to prevent or treat various conditions we’ve diagnosed. Then you might be admitted to the hospital for any one of a number of reasons and the doctors there might then send you home with a whole new set of prescriptions that can interact negatively with those you’re already taking.
Finally, because signs of dementia and other age-related disorders are generally expected in older adults, no one—the doctors, the patient’s family, or the patient—suspects that the problem might actually stem from polypharmacy.
Patients implicated, too
While not intending to blame the victim, it must be said that patients can also contribute to the problem, largely through their use of OTC drugs and unregulated supplements. One Harvard study found that nearly two-thirds of those over the age of 65 were using dietary supplements, including herbs and vitamins, while nearly 40 percent were taking OTC drugs.
We’ve said it before, but will reiterate: Such things are not necessarily harmless. Just because it’s available without a prescription doesn’t mean it’s safe for all people at all times under all conditions. In addition, the manufacture of herbal supplements is largely unregulated, so their use is additionally concerning.
For example, such common OTC drugs as antihistamines (Chlor-Trimeton, Benadryl) or sleep inducers (Nytol, Tylenol PM) can cause confusion, drowsiness, disorientation, blurry vision, and dizziness. Advil and aspirin can damage the liver, kidneys, or stomach, while Prilosec can interact with many prescription drugs.
Fish oil is thought to help heart health, but it can also thin the blood. This becomes problematic when a person is also taking prescription blood thinners. Aspirin is well known as a blood thinner, but so are ginger capsules and garlic supplements, among others.
This is just a tiny sliver of adverse side effects that can occur with OTC drugs and supplements, while prescription medications present their own set of side effects and possible interactions. Start combining these substances and you have a recipe for trouble.
Help us help you
This is why it’s critical that you inform us of all medications (prescription, OTC, and supplements) you’re taking. Bring along a list when you come for appointments, or if it’s too onerous to list them all, bring the bottles themselves. All of them: those kept in the medicine cabinet, the kitchen cabinet, your purse, office drawer, nightstand, wherever. (Once you see them all in one place, you may be surprised at how many there are!)
We want to know:
- what medications and supplements are you taking and why?
- how necessary is each drug you take?
- can any of them be stopped, or at least have their dosage reduced?
- might some of the symptoms you are experiencing be attributed to drug or supplement interactions?
We can only help you with the problem of polypharmacy if you provide all the information we need.