Medication Use in People Aged 90 Years and Older: A Nationwide Study

Objective

We aimed to describe the medications prescribed to people aged ≥90 years.

Design

A cohort study was performed using data from the year 2022.

Setting and Participants

Using data from the French National Health Data System, people aged ≥90 years affiliated with the general insurance scheme were included.

Methods

Medications dispensed, polypharmacy (≥5 drugs), and hyperpolypharmacy (≥10 drugs) were described in the total population and according to sex, age group (90–94 years, 95–99 years, ≥100 years), and place of residence. All analyses were conducted by quarter because of the high mortality rate in this population.

Results

In total, 696,498 subjects were included in the study. Among them, 73.2% were women, 75.9% were aged 90–94 years, and 2.9% were ≥100 years. Treatment for hypertension was prescribed to 77%, 50.4% had cardiovascular disease, and 17.7% had dementia. During the first quarter, 77.7% experienced polypharmacy. The most prescribed drugs were antihypertensive medications (73.8%), analgesics (58.8%), antithrombotics (55.3%), vitamin D (51.1%), and psychotropics (42%). There was a decrease in preventive drugs and an increase in symptom management drugs with increasing age. Subjects in nursing homes were more likely to take psychotropics and less likely to receive cardiovascular drugs. The results for the other quarters were similar.

Conclusions and Implications

Our results suggest a progressive, but probably insufficient decrease in the prescription of certain medications with age and to a lesser extent, in nursing homes. The discontinuation of treatments should be discussed in the context of short life expectancy to avoid the harmful effects of polypharmacy.