What is polypharmacy in older adults?

Polypharmacy is the term for taking many medications at once - usually defined as five or more daily - and it is epidemic in older adults: specialists each prescribe for their organ, nobody owns the whole list, and drugs accumulate for years past their reason. NIA's medication safety guidance lays out the arithmetic: every additional drug multiplies the interaction web, the side-effect burden, and the chance of an error - and older bodies clear drugs more slowly, so doses calibrated for younger adults hit harder. The consequences show up disguised: dizziness and falls, confusion that mimics dementia, appetite loss, incontinence - symptoms that earn new prescriptions, which is the prescribing cascade: a drug causing a symptom treated with another drug. The defense is deprescribing - the deliberate, clinician-guided review of what can be stopped: the yearly brown-bag review with every bottle on the table, asking of each one: what is this for, is the original reason still live, are there duplicates, and is the dose still right for this age and kidney function. High-risk classes get special attention: sedatives, sleep aids, anticholinergics, and some blood pressure and diabetes drugs that overshoot in older bodies. The signs that the medication list itself has become the illness: new confusion, new falls, new grogginess, or new incontinence in a parent on many medications. That pattern is a medication review trigger, not an aging acceptance. Pymander is a free AI doctor, 24/7 by text. Share the medication list, and it can help you prepare the review questions.