ELDERLY people receive no benefit from long-term use of many common medicines, and their health may even improve if they stop taking them, a University of Sydney study has found.
Coming off medicines that affect the brain and nervous system, such as sleeping pills and antidepressants, improved people's mental abilities and reduced the likelihood of falls - which cause a high rate of hospitalisation and death in older people, according to the analysis by David Le Couteur, director of the Centre for Education and Research on Ageing.
In up to 85 per cent of people aged 65 or older, blood pressure remained stable for six months to five years after withdrawal of blood pressure medicines, without any increase in the death rate.
Professor Le Couteur said his research was "in some ways a politically motivated exercise" intended to highlight the gulf between the results of drug company-sponsored medicine trials and how elderly people actually fare on the same drugs.
"There's lots of money to show medicines work and very little money to show they don't work," said Professor Le Couteur, who also works as a geriatrician at Concord Hospital.
Medicines were insufficiently studied in the elderly, who were usually not recruited to take part in drug trials, he said. Meanwhile, evidence of the effects of taking multiple drugs was "almost non-existent".
Medication reactions were the reason for up to one-third of hospital admissions of older people. "My first question with older people who are acutely ill is, 'What's changed recently with their medication?', " Professor Le Couteur said.
Among people 65 and older, 90 per cent were taking at least one medicine, while 40 per cent were taking five or more.
Professor Le Couteur's analysis - published in the journal Drugs & Aging - pooled the results of all previous research into medication withdrawal in older people to arrive at the most comprehensive conclusions to date.
In one New Zealand study, people taking sedatives or antidepressants were randomly assigned either to continue taking the medicines or were switched to a placebo with identical appearance. Those who took the placebo were 66 per cent less likely to suffer a fall over the following year.
Many medicines used in the elderly - like blood pressure or cholesterol-lowering drugs - were used to prevent illness rather than to relieve symptoms. But if people already had other illnesses and a poor quality of life, "none of those benefits [of prevention] are going to be accrued", Professor Le Couteur said. Treatment of the elderly required "a more complex and more equivocal approach", that took into account their life expectancy and degree of independence.
Helena Britt, director of the Family Medicine Research Centre at the University of Sydney, said the study would help draw attention to the issue of drug side-effects, particularly with multiple drug use, known as polypharmacy.
But she said there were barriers to taking elderly people off drugs that might not be beneficial. "I think it must be very difficult for GPs, remembering many medicines initially are prescribed by specialists," she said.
"Are you going to say, 'I don't agree with that'? It's a challenging position."