The explosion of new prescription and over-the – counter medications over the past few decades has created many options for physicians in treating disease, especially chronic conditions. Although advances in medication are highly desirable, there are hidden dangers for older adults. Until the late 1990s, clinical trials of new medications were not required to include older adults. Thus, for most of the medications on the market, it is unclear whether they are as effective for older adults as they are for younger or middle-aged adults. In addition, because of normative changes in metabolism with age, the effective dosage of medications may change as people get older, which can mean a greater risk of overdose or the need to increase the dose in order to get the desired effect.

When one considers that many of these newer, often more effective medications are very expen­sive, the ability of many older adults to afford the best medication treatments is questionable. The prescription drug insurance most older Americans have through Medicare leaves significant gaps for most; this means that many still cannot afford them because the deductibles and co-payments are too high for their fixed incomes. Additionally, figuring

out which option is best can be quite complex, serv­ing as a further barrier. (You can get much more information from the official Medicare prescription drug coverage website: http://www. medicare. gov/ pdphome. asp.)

As even more medications are developed and approved, the use of multiple medications will con­tinue and likely increase. When used appropriately, medications can improve people’s lives; when used inappropriately, they can cause harm. Understanding how medications work and how these processes change with age is extremely important.