polypharmacy in the elderly

Recently the famous singer Whitney Houston died from what sounds like an interaction of prescriptions drugs and alcohol.  Her death underscores that while a celebrity makes news with events like this, silently large numbers of adults have similar issues of mixing and improper use of prescription drugs. Indeed, it is a case of polypharmacy in the elderly.

Mike came to see me today concerned about his memory.  He is a very active 84 year old man and tells me that while driving home after a dinner at a friend’s home he could not remember making the two turn it took to get home.  A few days later he had another episode when he could not find his car keys only for his wife to find the left in the ignition.  He had a third episode when he lost track of his napkin in a restaurant. I am sure this might be a familiar refrain for many of us but when a man comes to my office alone he is frightened.  As the physician so am I.  The last thing I want to do is tell a man sitting all alone in front of me that he has Alzheimer’s disease. The fact is that he might have Alzheimer’s disease since it can occur in as many as 30% of 85 year olds, so just playing the percentages both of us has reason for concern.

I really liked this man, he reminds me of my father, not always in a good way, he likes to play doctor (my father was not a doctor either).  I decided to review his story in greater detail.  On at least 2 of these events he had an alcoholic beverage in the hours preceding the memory problem.  In the weeks before the events he placed himself back on a medication called Gabapentin to help relieve his neck pain and he started taking Hydrocodone for the neck pain as well.  To top things off he added Ambien ¼ of a 10mg tablet several nights a week to help him sleep.

After digging deeper into his history I had another plausible cause of his memory problem.

In this country, the statistic are staggering, one American dies from a prescription drug overdose every 19 minutes.  I hope I have saved Mike’s life.

What experiences do you have?

How do we make a difference?

Here is a link to get you thinking:  http://prescriptions.uchicago.edu/Polypharmacy/index.html

To a long and healthy life!


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