Drug Safety

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Frailty and Drug Safety at Older Ages

  • Martin GullifordEmail author

People over the age of 80 years represent the fastest growing sector in the population of most high-income countries [1]. This emerging demographic poses important challenges for drug safety. Older adults are highly exposed to prescription medications, with 40% of older non-institutionalized adults in the USA experiencing polypharmacy with five or more prescription medicines [2], often for substantial periods of time [3]. Polypharmacy increases with age and is particularly prevalent in care home populations [4]. The evidence base for pharmacological intervention at older ages is weak, as people of advanced ages have less often been included in clinical trials. Many studies have shown that at least 30–40% of medicines may be inappropriately prescribed at older ages [4, 5], based on criteria such as Beers and STOPP/START (Screening Tool of Older People’s Prescriptions/Screening Tool to Alert to Right Treatment) [6]. Consequently, older adults may be at increased risk of adverse drug...


Compliance with Ethical Standards


Martin Gulliford is supported by the National Institute for Health Research Biomedical Research Centre at King’s College London and Guy’s and St Thomas’ Hospital.

Conflict of interest

Martin Gulliford has no conflicts of interest that are directly relevant to the content of this commentary.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.School of Population Health and Environmental SciencesKing’s College LondonLondonUK

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