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What Are the Beers Criteria?

By Jillian O Keeffe
Updated May 17, 2024
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The Beers Criteria is a list of medications that is unsuitable for use in elderly people. Through research and experience, the medical profession realized that elderly people tended to be suffer more side effects from certain drugs than people of other ages. Doctors treating this age group of patients refer to the Beers Criteria to help decide which, if any, drugs are appropriate for their patients. The list may be updated to include new drugs and newly recognized side effects of older drugs.

Dr. Mark H. Beers is the doctor who first collated a list of medicines that were potentially unsuitable for the elderly. The basis for his interest in the risks of medication for the elderly was his research in the 1980s on mood-altering drug usage for people in nursing homes. His team of scientists noticed that a large proportion of these patients suffered serious side effects from these drugs such as muscle twitches or mental confusion.

Side effects are a risk for all medicines, but these side effects can vary according to the biology of individuals. As people age, their biology changes, and this can make the elderly more susceptible to side effects from certain drugs than younger people. Although medications have their uses, the benefit is always weighed against the potential for side effects. The Beers Criteria lays out a list of drugs which, when prescribed for people over the relatively young age of 65, are more likely to cause problems than to help medical conditions.

Research into this issue led to the publication of the Beers Criteria in 1991. This first draft of the medication list contained drugs such as antidepressants, antihistamines and drugs whose aim was to relax muscles. More drugs were added in a 2003 update of the Beers Criteria, which was arrived at through a review of the scientific evidence and the opinion of professionals in the field.

These include some types of non-steroidal anti-inflammatory drugs (NSAIDS) like piroxicam and naproxen. Some of the drugs in the 2003 beers Criteria are risky for all elderly people, whereas others are only unsuitable for people with specific medical conditions. Still other medicines were added because they appear to have no beneficial effect on people in this age group.

Nurses and doctors refer to the Beers Criteria when choosing treatments for medical issues in older people. Staff of nursing homes can also assess which drugs are safe for use with their patients with reference to the list. Although the list of medications can carry significant side effects, drugs on the Beers Criteria may still be prescribed for patients in this age group, if the doctor thinks the benefits for the individual are worth the risk.

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