If you take five or more medications daily, you have company. According to Johns Hopkins Medicine, 83% of adults in their 60s and 70s use at least one prescription drug, and about one-third take five or more.

This pattern has a name: polypharmacy. And while each medication might be necessary on its own, the combination carries risks worth understanding.

What Is Polypharmacy?

Polypharmacy generally means taking five or more medications regularly. Research shows this threshold is “associated with the risk of adverse outcomes such as falls, frailty, disability, and mortality in older adults.”

The numbers are striking:

  • Overall prevalence of polypharmacy is approximately 37% in older adults
  • In Sweden, 44% of older adults take 5+ medications
  • About 12% take 10 or more (excessive polypharmacy)

Why It Happens

Polypharmacy usually isn’t anyone’s fault—it’s a natural consequence of how healthcare works:

Multiple conditions, multiple specialists You might see a cardiologist for your heart, an endocrinologist for diabetes, and a rheumatologist for arthritis. Each prescribes what you need for their area.

The prescription cascade NIA describes how this works: You take a medication that causes a side effect. That side effect is treated with another medication. Which has its own side effects…

Guideline-driven care Clinical guidelines recommend specific medications for specific conditions. If you have several conditions, following all the guidelines leads to multiple medications.

Medications that continue indefinitely A medication started years ago may no longer be necessary, but it’s never been stopped.

The Real Risks

Hospital Admissions

Research shows that adverse drug effects account for 5% to 28% of acute geriatric hospital admissions. Polypharmacy is the fifth leading cause of U.S. deaths and accounts for nearly 30% of all hospital admissions.

Drug Interactions

Patients taking 5-9 medications have a 50% chance of experiencing an adverse drug interaction. The more medications you take, the higher this risk climbs.

Cognitive Effects

Johns Hopkins warns that oversedation is “one of the most important risks of polypharmacy in adults over age 60,” causing:

  • Drowsiness and confusion
  • Increased fall risk
  • Car and household accidents
  • Memory problems

Falls

Multiple medications—especially combinations of sedatives, blood pressure medications, and pain relievers—significantly increase fall risk in older adults.

Non-Adherence

The more complex the regimen, the harder it is to follow. Research indicates non-adherence rates in community-dwelling elderly adults range from 43% to 100% when complicated regimens are involved.

Common Problem Medications

The Merck Manual identifies drug categories of particular concern in older adults:

  • Anticholinergics (found in many OTC sleep aids, allergy medications, and bladder medications)
  • Benzodiazepines (anti-anxiety medications)
  • Opioids (pain medications)
  • Sleep aids
  • NSAIDs (ibuprofen, naproxen) taken long-term
  • Certain heart medications at high doses

What Can Be Done: Deprescribing

Deprescribing is the systematic process of identifying and discontinuing medications that are no longer needed or may be causing harm. It’s not about denying necessary treatment—it’s about finding the right balance.

When to Consider It

Good candidates for deprescribing review include:

  • Medications started long ago that haven’t been re-evaluated
  • Medications treating side effects of other medications
  • Duplicate therapies (two drugs that do similar things)
  • Medications with no clear current indication
  • “As needed” medications that are never used

How to Approach the Conversation

Bring up deprescribing with your doctor:

“I’m taking quite a few medications. Can we review whether I still need all of them?”

“This medication was started five years ago. Is it still necessary?”

“Are any of my medications treating side effects from other medications?”

What to Expect

Deprescribing should be:

  • Gradual – Many medications need to be tapered, not stopped suddenly
  • Monitored – Your doctor should track how you respond
  • Collaborative – You should understand what’s being changed and why
  • Reversible – If symptoms return, medications can be restarted

Protecting Yourself

Annual Medication Reviews

At least once a year, ask for a comprehensive medication review. This should include:

  • Confirming each medication is still needed
  • Checking for interactions
  • Evaluating doses
  • Looking for simplification opportunities

After Every Hospitalization

Hospital stays often result in medication changes. NIA recommends a thorough review after discharge to:

  • Understand any new medications
  • Check if pre-hospital medications should resume
  • Ensure nothing was inadvertently doubled

Use One Pharmacy and Doctor Coordination

When multiple specialists prescribe medications:

  • Make sure each knows what the others have prescribed
  • Use one pharmacy so they can screen for interactions
  • Ask your primary care doctor to coordinate

Keep a Complete List

Maintain an up-to-date list of all medications, including:

  • Prescription drugs
  • Over-the-counter medications
  • Vitamins and supplements
  • Herbal products

Bring it to every appointment.

Ask Questions

For every medication:

  • What is this for?
  • What are the risks and benefits?
  • How long should I take it?
  • Are there alternatives with fewer side effects?

For Caregivers

If you’re helping someone manage multiple medications:

Watch for warning signs:

  • Increased confusion or memory problems
  • New dizziness or falls
  • Changes in appetite or energy
  • Medications not working as well

Advocate at appointments:

  • Ask about medication reviews
  • Bring up deprescribing
  • Request simplification when possible
  • Ensure discharge medication reconciliation

Coordinate care:

  • Track all prescribers
  • Ensure information flows between doctors
  • Use one pharmacy

The Bottom Line

Polypharmacy is often unavoidable—managing multiple conditions requires multiple treatments. But that doesn’t mean the risks should be ignored.

Work with your healthcare providers to regularly evaluate whether each medication is still necessary, whether doses are optimal, and whether the regimen can be simplified. The goal isn’t fewer medications for its own sake—it’s the right medications at the right doses for your current situation.

OliveCare helps you track all your medications and prepare for conversations about optimizing your regimen.