A medication list can grow one prescription at a time. A new medicine is added after a hospital visit. An over-the-counter sleep aid becomes part of the evening routine. A supplement seems too ordinary to mention. Months later, no single person may have looked at the entire list together.
That is what a medication review after 65 is for. It is a structured conversation with a prescriber, pharmacist, or both about what you take, why you take it, how you use it, and whether the current plan still fits your health and goals.
A review is not a hunt for “bad” prescriptions. It is not permission to empty a pill organizer or skip a dose. Sometimes the safest outcome is to keep the plan exactly as it is. If a change makes sense, it should come with professional guidance.
Quick answer: Bring a complete list of prescriptions, nonprescription products, vitamins, supplements, inhalers, patches, creams, and injections. Include the dose, how often you use each item, and its purpose. Then ask the seven questions below. Do not stop or taper a medicine on your own.
Why medication decisions can change after 65
The American Geriatrics Society (AGS) explains that age-related changes can affect how the body breaks down or removes some medicines. A drug may remain in the body longer than it did years earlier. Health conditions, food, drinks, supplements, and other medicines can also affect how a treatment works.
That does not mean every older adult needs a lower dose. It means age, current health, the reason for treatment, and the rest of the medication list deserve another look from someone qualified to assess them.
The original reason for a prescription matters too. So does the intended duration. A medicine that made sense during a short illness or a difficult stretch of insomnia may need a different conversation than one used for an ongoing condition. The purpose of a review is to ask that question, not to decide the answer before the appointment.
What a new study found—and what it did not
Medication safety drew fresh attention in September 2026 after the University at Buffalo reported on a study published in the Journal of the American Geriatrics Society.
Researchers analyzed 2011–2022 US survey data from 2,796 community-dwelling adults aged 65 or older with dementia or mild cognitive impairment. The study tracked prescriptions for four groups of medicines the researchers classified as cognitive potentially inappropriate medications: anticholinergics, antipsychotics, benzodiazepines, and non-benzodiazepine hypnotics known as Z-drugs.
Exposure under that definition declined from 39.3% in 2011 to 29.3% in 2022. It was associated with poorer mental health-related quality of life and higher rates of emergency-department visits and hospitalizations. The researchers did not find an association with poor physical health-related quality of life or outpatient visits.
Those findings deserve careful wording. The study was cross-sectional. It found associations, but it could not show that the medicines caused those outcomes. It also could not show that reducing or stopping a medicine would improve quality of life or reduce hospital use. The authors called for longitudinal and interventional research to answer those questions.
The population was narrow as well: US adults aged 65+ with cognitive disorders who were living in the community. The results should not be stretched to all older adults, adults in their 40s or 50s, or people living in Canada.
“Potentially inappropriate” does not mean “automatically wrong”
The phrase can sound more alarming than it is.
The AGS Beers Criteria identifies medicines whose risks may be greater than their benefits for older adults. It helps healthcare professionals decide what deserves closer consideration.
AGS also warns against using the criteria by themselves to make medication decisions. A medicine on the list can still be a reasonable choice for a particular person. The diagnosis, dose, response, alternatives, and treatment goals all matter.
The same distinction applies to deprescribing. Deprescribing.org defines it as a planned and supervised process of reducing a dose or stopping a medicine that may be causing harm or may no longer offer enough benefit. The important words are planned and supervised.
Prepare one complete medication list
A useful review begins before the appointment. Do not rely on memory or assume the medical record contains everything.
The AGS medication-management guidance recommends including more than prescription pills:
| Include | Record beside it |
|---|---|
| Prescription medicines | Name, dose, frequency, and purpose |
| Over-the-counter products | How often you use them and why |
| Vitamins, minerals, and herbal products | Product name and amount used |
| Patches, inhalers, injections, creams, and ointments | Dose or strength, schedule, and purpose |
| Recently started, stopped, or changed items | Who recommended the change and when |
If possible, bring the bottles or current packaging along with the written list. Add any questions you do not want to forget. If you were recently in the hospital or saw another provider, make that clear at the start of the review.
Medication review after 65: seven questions worth asking
1. What is this medicine treating now?
Start with the purpose of each item. Ask what condition or symptom it addresses and whether that reason still applies.
This is especially helpful when a medicine was started years ago, during a hospital stay, or by a clinician you no longer see. The answer may be simple: yes, it is still doing an important job. If the purpose is unclear, write it down rather than guessing.
2. Is this still the right medicine and dose for me?
Age-related changes, new diagnoses, and the rest of your medication list can alter the balance between benefit and risk. Ask how your prescriber decided on the current dose and what would prompt a reassessment.
Do not reduce a dose because a general article or caution list makes you uneasy. The same medicine can be appropriate for one person and a poor fit for another.
3. Could this affect alertness, balance, memory, or another condition?
This question does not assume that a medicine is causing a problem. It invites your clinician or pharmacist to consider the medicine, the underlying condition, and other possible explanations for what you have noticed.
Be specific. “I have felt unsteady twice this month” is more useful than “This medicine seems bad.” If balance is one of your concerns, our guide to four mobility tests for healthy aging explains what simple function checks can—and cannot—tell you. Those tests do not replace a medication review.
4. Could this interact with anything else I take, eat, or drink?
Mention every prescription, OTC product, vitamin, herbal product, and supplement. Do not leave something off because it is “natural” or used only occasionally.
Food and beverages can matter too. Your clinician or pharmacist needs the complete picture to assess a possible interaction; an online checklist cannot make that judgment for you.
5. How long is this meant to continue?
Some treatments are intended for a limited period. Others are used long term. Ask which kind you have, how benefit is being judged, and when the plan should be reviewed again.
This question is not a request to stop. It makes the timeline visible. If there is no clear review point, ask what would trigger one.
6. What side effects should I watch for, and whom should I contact?
Ask for the most relevant warning signs in plain language. Find out whom to call if you notice a problem and whether there are routine checks connected to the medicine.
Keep notes about what happened and when, then report the concern. AGS guidance is direct on this point: do not stop a medicine without checking with your healthcare provider first.
7. If a change is appropriate, what is the supervised plan?
A safe plan may involve no change at all. It might involve adjusting timing or dose, switching treatments, monitoring, or a gradual reduction. The right approach depends on the medicine and the person.
Some medicines, including benzodiazepines, can cause withdrawal if stopped suddenly. Do not design your own taper or borrow somebody else’s schedule. Ask who will supervise the change, what follow-up is needed, and what to do if symptoms appear.
When should you ask for a medication review?
The sources used for this article do not recommend a universal review frequency. A review is particularly sensible when:
- you have recently left the hospital;
- another clinician has started, stopped, or changed a medicine;
- you have added an OTC product, vitamin, herbal product, or supplement;
- you cannot explain what one of your medicines is for;
- you have a possible side effect or interaction concern; or
- more than one clinician is involved and no one has reviewed the complete list with you.
You do not need to wait for a crisis. Ask whether a prescriber or pharmacist can go through the list with you and how that service works where you receive care. Availability and coverage vary by location and health system.
How a caregiver can help without taking over
A caregiver can collect containers, update the written list, note recent changes, and attend the appointment if the person taking the medicines wants them there. They can also make sure concerns and questions that are easy to forget reach the clinician.
The caregiver’s job is not to decide which medicine stays or goes. It is to make the conversation more complete.
Keeping the list current and making the appointment more complete is a basics-first habit. The same spirit appears in our article on why experts say the basics beat biohacks. A clear list and a good appointment may be less exciting than a new wellness trend, but they are far more actionable.
Frequently asked questions
What happens during a medication review?
A clinician or pharmacist goes through what you take, why you take it, the dose and schedule, possible side effects or interactions, and whether the current plan still fits your health and treatment goals. The review may confirm the existing plan or identify questions for follow-up.
Is a medication review the same as deprescribing?
No. A review examines the whole plan. Deprescribing is the planned, supervised reduction or stopping of a medicine that may be causing harm or may no longer provide enough benefit. A review does not automatically lead to deprescribing.
Does a medicine on the Beers Criteria need to be stopped?
Not automatically. AGS says the criteria should not be used alone to make treatment decisions, and a listed medicine may still be reasonable for an individual. Discuss it with the clinician who knows your health history and treatment goals.
Who can perform a medication review?
A prescriber, pharmacist, or care team may be involved. Services and professional scope differ by location and health system, so ask your clinic or pharmacy what is available.
What should I bring?
Bring a current list—or the containers themselves—for prescriptions, OTC products, vitamins, herbal products, supplements, patches, inhalers, injections, creams, and ointments. Record the dose, frequency, and purpose of each item.
Can I stop a medicine if I think it is causing a side effect?
Do not stop, skip, or taper it on your own. Contact your healthcare provider or pharmacist for guidance. Some medicines can cause withdrawal or other problems when changed abruptly.
Does the new study apply to everyone over 40?
No. It involved community-dwelling US adults aged 65+ with dementia or mild cognitive impairment. It does not establish the same associations in younger adults, all older adults, institutionalized populations, or Canadians.
A good review can end with “keep everything as it is”
That may be the most reassuring outcome of a medication review after 65. The goal is not to remove the greatest number of medicines. It is to understand the purpose of each one and make sure the full plan has been considered together.
Start with the list. Add the questions that matter to you. Then take both to a prescriber or pharmacist who can judge the benefits, risks, and options in the context of your health.
This article is for general education and does not replace individualized advice from a qualified healthcare professional who knows your health history and treatment goals. Do not stop, skip, taper, or change the dose of a medicine without professional guidance.
Sources
- Hsu H, Clark CM, Feuerstein S, et al. Cognitive Potentially Inappropriate Medications, Quality of Life, and Healthcare Use in Older Adults With Cognitive Disorders. Journal of the American Geriatrics Society. First published online August 4, 2026. DOI: 10.1111/jgs.70607.
- University at Buffalo. Common drugs linked to poorer quality of life and higher hospital use among older adults with cognitive disorders. September 16, 2026.
- KFF Health News. 3 Common Drugs Older Adults Might Be Overusing. September 17, 2026.
- American Geriatrics Society, HealthInAging.org. Medications Work Differently in Older Adults. Accessed September 17, 2026.
- American Geriatrics Society, HealthInAging.org. Medications That Older Adults Should Avoid or Use With Caution. Accessed September 17, 2026.
- American Geriatrics Society, HealthInAging.org. What Older Adults Can Do to Manage Medications. Accessed September 17, 2026.
- Deprescribing.org. What Is Deprescribing?. Accessed September 17, 2026.
Accuracy note
The study discussed here was observational and cross-sectional. Its associations do not establish cause and effect or prove that changing medication exposure improves outcomes. Population, geography, diagnosis scope, and time limits have been preserved. The article was researched on September 17, 2026, and should be reviewed if clinical guidance or the cited sources change.