Many family caregivers know that medications can cause side-effects in older people, and may worry that perhaps their loved ones are being affected by medications.
It’s a very reasonable concern to have. Studies have shown that older adults, especially those taking multiple prescription medications, often experience potentially serious side-effects from their medications.
But having talked with many family caregivers over the years, I’ve found that even the savvy ones often haven’t heard of the “Beer’s List.”
What is the Beer’s List?
Technically known as the “American Geriatrics Society Updated Beers Criteria: Medications that Older Adults Should Avoid or Use with Caution,” this is a carefully reviewed list of medications that are “potentially inappropriate” for older adults, and includes many of the medications that we geriatricians tend to stop or reduce in our patients. (Seriously, identifying and reducing these medications is a big part of my clinical practice!)
Although mainly meant to be used as a reference by clinicians, the American Geriatrics Society(AGS) also provides the information in an easier-to-read format here.
What to do if you realize that you or a loved one is taking a potentially risky medication? Conveniently, AGS addresses this very issue and provides a handy online guide on “What to Do and What to Ask Your Healthcare Provider if a Medication You Take is Listed in the Beers Criteria for Potentially Inappropriate Medications to Use in Older Adults.”
If you’re a caregiver: Have you ever used the Beer’s list as a resource? Other ideas for how caregivers can be empowered to check on their loved one’s medications?
Eddie says
Hello Dr.Kernisan and Dr.Didyk
I read your article regarding 4 medications that dampen or slow brain function.
I am 28 y/o with treatment resistance Anxiety (severe generalized Anxiety disorder since 17 y/o).
I have tried several meds with limited or no success, my psychiatrist finally added me Seroquel XR and it changed my life literally. I am now on Seroxat and Seroquel.
No therapy alone works in my situation. It must be a combination of meds and therapy.
Should I quit this good life for longer term brain health or what is your advice to me?
Nicole Didyk, MD says
I’m so glad you found a treatment that works for you, and many people with anxiety or depression require more than one medication to manage their symptoms.
While there is an association between long term use of anticholinergic medications and impaired cognition in older age, it’s also vital to manage serious conditions like anxiety throughout the lifespan. If it’s necessary to take medications with anticholinergic properties in order to work, have healthy relationships, and maintain other aspects of health, then it may be a trade off worth making.
Regular sleep, exercise and learning relaxation techniques can also help with anxiety management, and may reduce the need for medications long term.
Eddie says
Thank you Dr.Didyk
By the way without these two medications I already have cognitive impairment meaning that my concentration is low, my working memory is weak too and it is why I was terminated twice from my university as I could not pass but I carried on with life and I am doing well without university. I also have a kind of foggy brain and thus a bad memory in general. Is this what you mean by cognitive impairment in the future?
As I am 28 now, after how many years do you think this cognitive impairment will start to develop?
And after how many years I could develop Tardiv Dyskensia being on this medication?
Please tell it to me as it is, I want to know my options very clearly.
I cannot thank you enough
Nicole Didyk, MD says
The data that we have refers more to cognitive impairment in later life, after the age of 65 for example. It seems that those who have a higher intake of anticholinergic medication throughout life may be at higher risk of dementia in their elder years. I hope that provides some clarity.
Tardive dyskinesia can develop within 6 months of starting to take an antipsychotic medication, or comes on after a medication change or withdrawal. The newer antipsychotics (also called “atypical neuroleptics”) are less likely to cause TD, and it’s also less frequent when lower doses are used.
Lyn Daly says
Where is the list? I have followed about twenty links so far and just get teasers but no list of dangerous drugs for elderly. V frustrating, it is vital i find out as my Dad needs this information desperately. Can you help please. lyn
Nicole Didyk, MD says
Hi Lyn. Sorry that you weren’t able to access the Beers list. As Dr. K explains:
“Now, I have good news and bad news about the Beers criteria.
The good news is that they were just updated and revised, so the Beers Criteria published in January 2019 is about as up-to-date as you can get for this type of guideline document. (Yay!)
The bad news is that this year, the American Geriatrics Society (AGS), which has historically made the list freely available to the public on HealthinAging.org, has not released the updated information for free on its page about the Beers Criteria. (Bummer!)
Instead, they’ve posted a notice that “To access the complete AGS Beers Criteria® and its related resources, please visit GeriatricsCareOnline.org.” From there, the article is available for purchase.
(My suggestion for those who really want the list: consider getting the handy 2019 AGS Beers Criteria® Pocketcard, which is $9.99. Or, ask your health provider to print it for you.) “
Hope that is helpful, and sorry again for the frustration!
judy says
I am currently trying to put together all of my moms medical info on to my lap top. Do you know what program I can down load to organize everything.
Leslie Kernisan, MD MPH says
Great that you are trying to organize your mother’s medical information!
Unfortunately, I don’t have a particular program to recommend at this time. I haven’t researched newer programs for a few years now. New services can be quite innovative but some of them fold or get bought out quickly. Microsoft Healthvault is older and well-established; it hasn’t been revamped in a while, as far as I know, but does work. Alternatively, some people use information/note-keeping apps such as Evernote, or OneNote, or even Dropbox. I have more on tools to keep medical information here:
Tools for caregivers: Keeping & Organizing Medical Information
This article is also relevant: How to Use a Personal Health Record to Improve an Older Person’s Healthcare
Just for medications, there are a variety of apps and services available, but I don’t recommend a particular one at this time.
Acqua says
Try the CareZone App. You can track medications, refills, doctors contact info, appointments, journal routine and unexpected events including flu shot dates, etc, record copies of insurance and ID cards, and SO much more! Been my favorite for MANY years!
Leslie Kernisan, MD MPH says
Thanks for sharing this suggestion. I have tried CareZone in the past, and it’s true that some families really like it.
I like that the information can be accessed via web browser or app.
Dr Susan Zimmer says
Are any of your publications available as free handouts to give to patients?
thank you
Leslie Kernisan, MD MPH says
Thanks for your interest in my resources. So far I don’t have anything beyond what is on this website.