April 18, 2019
2019 Beers Criteria Update: The American Geriatrics Society (AGS) produces and regularly updates the Beers Criteria, a list of medications that are potentially inappropriate for use in adults aged 65 years and older. A 13-member interprofessional panel systematically assessed the evidence since the last update in 2015 and published the latest update in January 2019. The new AGS Beers Criteria® includes 30 medications/medication classes that are potentially inappropriate in older adults. The criteria also contains 40 medications/medication classes that should be avoided in older people with certain conditions or to be used with caution. Twenty-five medications/medication classes were removed from the AGS Beers Criteria® in the 2019 update. The AGS Beers Criteria® is a tool for safe medication management in older adults.
The population of persons age 65 years and older is increasing.
Age-related changes in physiology can affect the pharmacokinetics and pharmacodynamics of numerous drugs.
Improving and maintaining functional status is a cornerstone of care for older adults.
Drug-related problems in older adults are common and cause considerable morbidity.
Pharmacists can play a major role in optimizing drug therapy and preventing drug-related problems in older adults.
Pharmacotherapy for older adults can cure or palliate disease as well as enhance health-related quality of life (HRQOL). Health-related quality of life considerations for older adults include focusing on improvements in physical functioning (eg, activities of daily living), psychological functioning (eg, cognition, depression), social functioning (eg, social activities, support systems), and overall health (eg, general health perception).1
Despite the benefits of pharmacotherapy, HRQOL can be compromised by drug-related problems. Prevention of drug-related adverse consequences in older adults requires that health professionals become knowledgeable about a number of age-specific issues. To address these knowledge needs, this chapter discusses the epidemiology of aging; physiologic changes associated with aging, with emphasis on changes that can affect the pharmacokinetics and pharmacodynamics of drugs; clinical conditions commonly seen in older adult patients; epidemiology of drug-related problems in older adults; and an approach to reducing drug-related problems through the provision of comprehensive geriatric assessment.
The older American population is highly diverse and heterogeneous with respect to health status. The demographics and health characteristics of persons age 65 to 74 years differ from those of persons 85 years of age and older, as do those of persons who are institutionalized compared with those living in the community. Teasing apart the various threads of wellness and illness, independence and dependence, and function and dysfunction makes the available demographic and health status data relevant for clinical practice. Understanding the diversity and growth of older populations will allow society to plan for the training, research, and resources needed for future clinical practice and adequate healthcare.
The proportion of the population age 65 and older is increasing. In 2010, ...