Beers Criteria Warns Us About High-Risk Medications in the Elderly

Beers criteria guide us towards safer drug use in seniors

Beers criteria prescription drugs
Beers criteria has nothing to do with alcohol but could help to decrease side effects from your medications.. Alan Graf/Cultura/Getty Images

Americans take a lot of medications. The U.S. Census Bureau reported the average American filled 12.2 prescriptions in 2013. The number increased to 27.8 prescriptions for those over 65 years old. When we look closer, we see that seniors aged 65-79 years old used 27.3 prescriptions per year and those over 80 years old used 29.1 per year.

Even if a percentage of these prescriptions represent refills of the same medications, seniors are still taking multiple medications at a time.

A 2013 study in Mayo Clinic Proceedings showed that 51.6 percent of Americans take medications in at least two drug categories and 21.2 percent in five or more categories per year.

Each prescription medication has its own side effect profile and medications taken together increase the risk for drug-drug interactions. Let us not forget that over-the-counter medications, even herbal supplements, can cause their own problems. "Natural" does not necessarily mean safe.

Not only do seniors take more medications but they also have more health problems. As many as 32 percent of Medicare beneficiaries have two to three chronic illnesses, 23 percent four to five and 14 percent six or more. Certain medications may cause complications depending on what medical problems you have.

Dr. Mark Beers, a geriatrician, established criteria in 1991 to decrease risky medication use in seniors. The initial Beers Criteria were aimed to decrease high risk medication use for seniors living in long-term care facilities.

The criteria was updated in 1997, 2003 and 2012 and has been expanded to include medication use regardless of where you live, in a hospital, skilled nursing facility or home. Experts in different geriatric specialties came together to establish the guidelines using evidence-based medicine and systematic reviews.

The most updated 2012 criteria were broken down into three categories:

  • Potentially inappropriate medications and classes to avoid in older adults
  • Potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the listed drugs can exacerbate
  • Medications to be used with caution in older adults

While it is not advised that you take beer with your medications, it is recommended that you decrease use of medications that fall under Beers criteria. Take a good look at your medication list. Are any of your medications one of the fifty-three listed on the Beers list?


Campanelli CM. American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults:The American Geriatrics Society 2012 Beers Criteria Update Expert Panel. J Am Geriatr Soc. 2012 Apr; 60(4): 616–631.

Centers for Medicare and Medicaid Services. Chronic Conditions Among Medicare Beneficiaries, Chartbook: 2012 Edition. Accessed August 20, 2015.

IMS Institute for Healthcare Informatics. Medicine Use and Shifting Costs of Healthcare. Published April 2014. Accessed August 20, 2015.

Zhong W, Maradit-Kremers H, St. Sauver JL et al. Age and Sex Patterns of Drug Prescribing in a Defined American Population. Mayo Clinic Proceedings. 2013 Jul; 88(7): 697–707.

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