Reviewing an elderly patient's medications

Medication review is the starting point for comprehensive rehabilitation of an elderly person in order to support physical or mental functional capacity.An elderly patient appreciates a clear diagnosis and an approach where the doctor both listens and discusses the matter before starting or reducing medication – this will also improve patient compliance. An improved quality of life as the aim of medication is emphasized in elderly patients. Problems encountered include both underuse, which is often associated with underdiagnosis (e.g. memory diseases, heart disease, disease prophylaxis, pain), and inappropriate medication (medication without a clear indication, or a drug for which the risk of adverse events outweighs the clinical benefit). It must be borne in mind that some of the patient’s symptoms may not be due to an illness but are an adverse effect of a medicine. Some medicines may often cause adverse effects in elderly patients (e.g. long-acting benzodiazepines, antipsychotic drugs, anticholinergic drugs, oral antidiabetic drugs and anti-inflammatory analgesics). The possibility of dehydration and undernourishment should be remembered both in patients living at home and those living in a care facility. Sufficient intake of protein from food is of particular importance for drug metabolism. Protein malnutrition and vitamin deficiencies develop easily and insidiously in elderly persons .