Older Adults, Polypharmacy and Supplements

Why this matters in a longevity library

Longevity products are often aimed at older adults, who are also the group most likely to take several medicines. This page describes how often medicines and supplements are combined, what is known about the risks, and how that fits with the evidence for living longer. It is information only. It does not tell anyone to start, stop or change any medicine or supplement; talk with your prescriber or pharmacist first.

Evidence labels used: established, promising but limited, mixed, insufficient evidence, no good evidence of benefit and evidence of harm.

What "polypharmacy" means

Polypharmacy means using many medicines together, but there is no single agreed definition. A systematic review of 110 articles found 138 definitions, and the most common was five or more medicines daily. [1][2] Numbers alone do not show whether the combination is appropriate; some medicines on a long list are needed.

How common is combining medicines and supplements?

• United States, ages 62 to 85. In a national in-home survey, use of dietary supplements rose from 51.8% to 63.7% between 2005-2006 and 2010-2011, and concurrent use of five or more prescription medicines rose from 30.6% to 35.8%. About 15% of older adults were potentially at risk for a major drug-drug interaction. [3][4][5] These are survey figures from that period, not trial results.
• A small UK survey. At two general practices, 155 older adults returned a questionnaire (a 38.8% response rate). [6] Among them, 33.6% used herbal products or supplements along with prescriptions, [7] and 16 participants (32.6%) were at risk of potential adverse interactions. [8] Because the sample is small and few responded, treat these figures as a rough example, not a rate for any country.

The authors of the UK study concluded that clinicians should routinely ask older adults about herbal and supplement use. [9]

What the evidence says about supplements for living longer

• The National Institute on Aging says that advertisements for dietary supplements sometimes promise they will help you live longer, but often there is little, if any, science supporting these claims. [13]
• NCCIH reports that most research shows multivitamins do not result in living longer. [14] Label: no good evidence of benefit for living longer. See multivitamins and longevity trials.
• The US Preventive Services Task Force recommends against beta carotene or vitamin E supplements to prevent cardiovascular disease or cancer, and finds the evidence insufficient for multivitamins and most single nutrients. [15] Label: evidence of harm for beta carotene and vitamin E, insufficient evidence for the rest.
• A Cochrane review of 78 trials found no evidence to support antioxidant supplements for prevention. [16]

Some nutrients are different because deficiency is a medical problem. The National Institute on Aging says people over 50 may need more of some vitamins and minerals, [17] and that a doctor or dietitian can say whether a change in diet or a supplement is needed. It gives vitamin B12 as an example because some older adults have trouble absorbing the form found in food. [18][19] Guides: vitamins for older adults and protein for older adults.

Related guides

Older adults and natural remedy safety, medicines, supplement burden and older adults and healthy aging.