For older adults
The same prescription is not the same medicine at 75
Bodies change how they handle medicine, and those changes are invisible from the outside. Here is what to ask, and how to get a real medication review instead of another refill.
What changes with age
Kidneys and liver clear many drugs more slowly as we age, so a standard dose can build up and act like a larger one. Body composition shifts. The brain becomes more sensitive to anything sedating. Blood pressure responds differently, which is how a medicine that was fine for twenty years suddenly causes a fall.
Falls are the injury that changes a life at this age, and medications are among the most common causes — and the most fixable. That is the single best reason to review the whole list once a year.
Medicines worth asking about
Sleeping pills and anti-anxiety medicines
Benzodiazepines and the “Z-drugs” raise confusion and fall risk for older adults, especially after months of nightly use. Ask what the plan is for getting off them, and how to do it safely.
Opioid pain relievers
Particularly risky combined with anything else sedating, including alcohol and sleep aids. Ask whether the dose is still doing what it was meant to do.
Some over-the-counter sleep aids and allergy medicines
Anticholinergic drugs can cause confusion and memory complaints that get mistaken for dementia. They are on the shelf, which makes them easy to overlook.
Daily over-the-counter pain relievers
Regular use carries stomach, kidney, and blood pressure risk that adds up quietly over years.
None of these is automatically wrong. All of them are worth an explicit conversation once a year, with the bottles on the table.
How to get a medication review
Medicare covers an annual wellness visit, and a comprehensive medication review is the kind of care you are entitled to ask for by name. If you are on Original Medicare, your State Health Insurance Assistance Program offers free, unbiased help understanding what is covered — start there rather than with a sales call.
Bring every bottle: prescriptions, over-the-counter, supplements, eye drops, creams, inhalers, and anything from a dispensary. Include things you only take sometimes. A review of half the list is not a review.
The questions: What is each of these for? Is it still doing that? Could any be lowered, or stopped? Can two be combined into one? What happens if I miss a dose?
If a new medicine is added, write down the date you started it. If something feels wrong in two weeks, you will want to know exactly what changed and when.
If you are considering cannabis at this age
Two cautions matter more here than for younger people. First, cannabis can lower blood pressure and affect balance, and fall risk climbs steeply with age. Second, there is very little research on older adults specifically, and no dosing standard. Any product is an experiment.
An experiment is worth doing with your doctor informed rather than in secret. Tell them what you are using, how often, and whether it seems to help. That is the information they need to keep you safe.
And if a doctor tells you that a symptom is just aging, you are allowed to ask what else it could be. Sometimes the answer is age. Sometimes it is the ninth bottle on the table.
Print this and take it in
A one-page list of questions for your next appointment, formatted to print cleanly.
The question checklistMore for older adults
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