Medication and the Aging Organism

A Guide for the Non-Prescribing Clinician
  • Nancy Keuthen
Part of the Applied Clinical Psychology book series (NSSB)


The elderly as an age group are major consumers of prescription medications. The total number of drugs prescribed for the elderly is disproportionately high, relative to their representation in the population. Individuals 65 years of age and older spend one-quarter of the total national expenditure for medication (Vestal, 1984), though they comprise under 12% of the population (Bureau of the Census, 1985). Nearly two-thirds of this group receive medications regularly (Guttmann, 1978). Physicians often simultaneously prescribe from three to twelve medications per day for elderly patients (Lamy, 1980) and more than thirteen prescriptions per year (Lamy & Vestal, 1976). Less than 5% of all individuals 65 years of age or older abstain from all drug use (Guttmann, 1978). The elderly also use over-the-counter preparations, but it is unclear from existing statistics whether or not they use them more than other age groups.


Tardive Dyskinesia Psychoactive Drug Medication Compliance American Geriatrics Society Drug Side Effect 
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  1. Abrahams, M. J., Armstrong, J., & Whitlock, F. A. (1970). Drug dependence in Brisbane. Medical Journal of Australia, 2, 397–404.PubMedGoogle Scholar
  2. Albanese, H., & Gaarder, K. (1977). Biofeedback treatment of tardive dyskinesia: Two case reports. American Journal of Psychiatry, 134, 1149–1150.PubMedGoogle Scholar
  3. Beardsley, R., Heaton, A., Kabat, H., & Martilla, J. (1975). Patterns of drug use in nursing home patients. Minneapolis: University of Minnesota College of Pharmacy.Google Scholar
  4. Boston Collaborative Drug Surveillance Program. (1973). Clinical depression of the central nervous system due to diazepam and chlordiazepoxide in relation to cigarette smoking and age. New England Journal of Medicine, 288, 277–280.CrossRefGoogle Scholar
  5. Brand, E N., & Smith, R. T. (1974). Medical care and compliance among the elderly after hospitalization. International Journal of Aging and Human Development, 5, 331–346.PubMedCrossRefGoogle Scholar
  6. Brocklehurst, J. C., Carty, M. H., Leeming, J. T., & Robinson, J. M. (1978). Medical screening of old people accepted for residential care. Lancet, 1, 141–142.CrossRefGoogle Scholar
  7. Brown, M. M., Boosinger, J. K., Henderson, M., Rife, S. S., Rustia, J. K., Taylor, O., & Young, W. W. (1977). Drug-drug interactions among residents in homes for the elderly—a pilot study Nursing Research, 26, 47–52.PubMedGoogle Scholar
  8. Bureau of the Census. (1985). Statistical abstract of the United States: 1986 (106th ed.). Washington, DC: U.S. Government Printing Office.Google Scholar
  9. Capel, W. C., & Stewart, G. T. (1971). The management of drug abuse in aging populations: New Orleans findings. Journal of Drug Issues, 1, 114–120.Google Scholar
  10. Cooper, J. W., Jr. (1975). Implications of drug reactions—recognition, incidences, and prevention. Rhode Island Medical Journal, 58, 274–280.PubMedGoogle Scholar
  11. Dapcich-Miiira, E., & Hovell, M. F. (1979). Contingency management of adherence to a complex medical regimen in an elderly heart patient. Behavioral Therapy, 10, 193–201.CrossRefGoogle Scholar
  12. Davies, R. K. (1971). Confusional episodes and antidepressant medication. American Journal of Psychiatry, 128, 95–99.PubMedGoogle Scholar
  13. Doyle, J. P., & Hamm, B. M. (1976). Medication use and misuse study among older persons. Jacksonville, FL: The Cathedral Foundation of Jacksonville.Google Scholar
  14. Farrar, W. B. (1976). Using electromyographic biofeedback in treating oraficial dyskinesia. Journal of Prosthetic Dentistry, 35, 384–387.PubMedCrossRefGoogle Scholar
  15. Frederiksen, L. W., & Rosenbaum, M. S. (1979). The behavioral control of tardive dyskinesia: Evaluation of three types of feedback. Journal of Behavior Therapy and Experimental Psychiatry, 10, 229–302.CrossRefGoogle Scholar
  16. George, A. (1972). Survey of drug use in a Sydney suburb. Medical Journal of Australia, 2, 233–237.PubMedGoogle Scholar
  17. German, P. S., Klein, L. E., McPhee, S. J., & South, C. R. (1982). Knowledge of and compliance with drug regimens in the elderly Journal of the American Geriatrics Society, 30, 568–571.PubMedGoogle Scholar
  18. Gibson, S. S. J. M., & O’Hare, M. M. (1968). Prescription of drugs for old people at home. Gerontologica Clinica, 10, 271–280.CrossRefGoogle Scholar
  19. Gillies, M. A., & Skyring, A. P. (1972). The pattern and prevalence of aspirin ingestion as determined by interview of 2921 inhabitants of Sydney. Medical Journal of Australia, 1, 974–979.PubMedGoogle Scholar
  20. Goldberg, P. B., & Roberts, J. (1983). Pharmacologic basis for developing rational drug regimens for elderly patients. The Medical Clinics of North America, 67, 315–331.PubMedGoogle Scholar
  21. Greenblatt, D. J., Allen, M. D., & Shader, R. I. (1977). Toxicity of high dose flurazepam in the elderly. Clinical Pharmacological Therapeutics, 21, 355–361.Google Scholar
  22. Guttmann, D. (1978). A study of drug-taking behavior of older Americans. In C. R. Beber & P. P. Lamy (Eds.), Medication management and education of the elderly (pp. 201–230). Amsterdam: Excerpta Medica.Google Scholar
  23. Hamblin, D., Wells, F. O., & Ellis, S. (1979). A study of the compliance to prescribed treatment of patients under antihypertensive treatment. Journal of Clinical and Hospital Pharmacy, 4, 41–49.Google Scholar
  24. Hamilton, L. D. (1966). Aged brain and the phenothiazines. Geriatrics, 21, 131–138.PubMedGoogle Scholar
  25. Hemminki, E., & Heikkila, J. (1975). Elderly people’s compliance with prescriptions and quality of medication. Scandinavian Journal of Social Medicine, 3, 87–92.PubMedGoogle Scholar
  26. Hurwitz, M. (1969). Predisposing factors in adverse reactions to drugs. British Medical Journal, 1, 536–539.PubMedCrossRefGoogle Scholar
  27. Hussar, D. A. (1978). Patient noncompliance. Journal of American Pharmacological Association, 15, 183–190.Google Scholar
  28. Hussian, R. (1981). Geriatric psychology: A behavioral perspective. New York: Van Nostrand Reinhold.Google Scholar
  29. Ingman, S. R., Lawson, I. R., Pierpadi, P. G., & Blake, P. (1975). A survey of the prescribing and administration of drugs in a long-term care institution for the elderly. Journal of American Geriatrics Society, 23, 309–316.Google Scholar
  30. Johnson, D. A. W. (1972). The psychiatric side effects of drugs. Practitioner, 209, 320–326.PubMedGoogle Scholar
  31. Kalchthaler, T., Coccaro, E., & Lichtiger, S. (1977). Incidence of polypharmacy in a long-term care facility Journal of American Geriatrics Society, 25, 308–313.Google Scholar
  32. Kane, J. M., & Smith, J. M. (1982). Tardive dyskinesia. Prevalence and risk factors, 1959 to 1979. Archives of General Psychiatry, 39, 473–481.PubMedCrossRefGoogle Scholar
  33. Lamy, P. P. (1980). Prescribing for the elderly. Littleton, MA: PSG Publishing.Google Scholar
  34. Lamy, P. P., & Vestal, R. E. (1976). Drug prescribing for the elderly. Hospital Practice, 11, 111–118.PubMedGoogle Scholar
  35. Leach, S., & Roy, S. S. (1986). Adverse drug reactions: An investigation on an acute geriatric ward. Age and Aging, 15, 241–246.CrossRefGoogle Scholar
  36. Lenhart, D. G. (1976). The use of medications in the elderly population. Nursing Clinics of North America, 11, 135–143.PubMedGoogle Scholar
  37. MacDonald, E. T., MacDonald, J. B., & Phoenix, M. (1977). Improving drug compliance after hospital discharge. British Medical Journal, 2, 618–621.PubMedCrossRefGoogle Scholar
  38. Maultsby, M. C., Jr., & Fortier, R. H. (1981). Patterns of drug use by normal elderly people. Lexington, KY: University of Kentucky Medical Center, Rational Behavior Therapy Center.Google Scholar
  39. Morrant, J. C. A. (1975). Medicines and mental illness in old age. Canadian Psychiatric Association Journal, 20, 309–312.PubMedGoogle Scholar
  40. National Center for Health Statistics. (1977). Health interview survey: United States1975. Rockville, MD: Health Resources Administration.Google Scholar
  41. O’Donnell, J. A. (1969). Narcotic addicts in Kentucky. Washington, DC: Public Health Service Publication.Google Scholar
  42. Ouslander, J. G. (1981). Drug therapy in the elderly Annals of Internal Medicine, 95, 711–722.PubMedCrossRefGoogle Scholar
  43. Parry, H. J., Blater, M. B., Mellinger, G. D, Cisin, I. H., & Manheimer, D. I. (1973). National patterns of psychotherapeutic drug use. Archives of General Psychiatry, 28, 769–783.CrossRefGoogle Scholar
  44. Pascarelli, E. F. (1974). Drug dependence: An age-old problem compounded by old age. Geriatrics, 29, 109–115.PubMedGoogle Scholar
  45. Paulson, G. W. (1968). “Permanent” or complex dyskinesias in the aged. Geriatrics, 9, 105–110.Google Scholar
  46. Phillipson, R. (1976). Drugs and the aged: Policy issues and the utilization of research findings. Paper presented at the American Association for the Advancement of Science, Boston, MA.Google Scholar
  47. Prien, R. F. (1975). A survey of psychoactive drug use in the aged at Veterans Administration hospitals. In S. Gershon & S. Raskin (Eds.), Aging (pp. 143–154). New York: Raven Press.Google Scholar
  48. Raffoul, P. R., Cooper, J. K., & Love, D. W. (1981). Drug misuse in older people. The Gerontologist, 21, 146–150.PubMedCrossRefGoogle Scholar
  49. Sackett, D. L., & Haynes, R. B. (Eds.). (1976). Compliance with therapeutic regimens. Baltimore, MD: Johns Hopkins Press.Google Scholar
  50. Salzman, C., & Shader, R. I. (1974). Psychopharmacology in the aged. Journal of Geriatric Psychiatry, 7, 165–184.PubMedGoogle Scholar
  51. Schuckit, M. A. (1977). Geriatric alcoholism and drug abuse. Gerontologist, 17, 168–174.PubMedCrossRefGoogle Scholar
  52. Schuckit, M. A., & Moore, M. A. (1979). Drug problems in the elderly. In O. Kaplan (Ed.), Psychopathology of aging (pp. 229–241). New York: Academic Press.Google Scholar
  53. Schwartz, D., Wang, M., Feitz, L., & Goss, M. E. W. (1962). Medication errors made by elderly chronically ill patients. American Journal of Public Health, 52, 2018–2029.PubMedCrossRefGoogle Scholar
  54. Shader, R. I. (1972). Psychiatric complications of medical drugs. New York: Raven Press.Google Scholar
  55. Stephens, R. C., Haney, C. A., & Underwood, S. (1982). Drug taking among the elderly. Washington, DC: U.S. Government Printing Office.Google Scholar
  56. Subcommittee on Long Term Care of the U.S. Senate Special Committee on Aging. (1975). Drugs in nursing homes: Misuse, high cost and kickbacks. Washington, DC: U.S. Government Printing Office.Google Scholar
  57. Swanson, D. W., Weddige, R. L., & Morse, R. M. (1973). Abuse of prescription drugs. Mayo Clinic Proceedings, 48, 359–367.PubMedGoogle Scholar
  58. Taylor, C. B., Zlutnick, S. I., & Hoele, W. (1979). The effects of behavioral procedures on tardive dyskinesia. Behavior Therapy, 10, 37–45.CrossRefGoogle Scholar
  59. Thompson, T. L., Moran, M. G., & Nies, A. S. (1983). Psychotropic drug use in the elderly New England Journal of Medicine, 308, 134–138.PubMedCrossRefGoogle Scholar
  60. Vestal, R. E. (Ed.). (1984). Drug treatment in the elderly. Boston, MA: ADIS Health Services Press.Google Scholar
  61. Wandless, I., & Davies, J. W. (1977). Can drug compliance in the elderly be improved? British Medical Journal, 1, 359–361.PubMedCrossRefGoogle Scholar
  62. Weintraub, M., Au, W. Y.-W., & Lasagna, L. (1973). Compliance as a determinant of serum digoxin concentration. Journal of the American Medical Association, 244, 481–485.CrossRefGoogle Scholar
  63. Williams, T. F., Hill, J. G., Fairbank, M. E., & Knox, K. G. (1973). Appropriate placement of the chronically ill aged—a successful approach by evaluation. Journal of the American Medical Association, 226, 1332–1335.PubMedCrossRefGoogle Scholar
  64. Williamson, J., & Chopin, J. M. (1980). Adverse reactions to prescribed drugs in the elderly: A multicenter investigation. Age and Aging, 9, 73–80.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1991

Authors and Affiliations

  • Nancy Keuthen
    • 1
  1. 1.Psychosomatic Medicine UnitMassachusetts General HospitalBostonUSA

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