Guilty until proven innocent
Dr. Jerry Gurwitz, the chief of geriatric medicine at the University of Massachusetts Medical School, says that one of the most valuable lessons he learned from his mentor in medical school was that "any new symptom in an older person should be considered a drug side effect until proven otherwise." If only more mainstream physicians had mentors like Dr. Gurwitz's, maybe getting older wouldn't be such a devastating, drug-laden process for so many people. And maybe cases of Alzheimer's wouldn't be reaching epidemic proportions. You see, many of the symptoms of the drug interactions many seniors experience mirror Alzheimer's and similar conditions like Pick's disease. That's precisely what happened to Nancy Burns several years ago. The problem emerged when her daughter, Kelli, received several increasingly confused, slurred answering machine messages from Burns, asking what day—and even what time of day—it was. Kelli and her brother Brad took their mother to the emergency room where doctors ruled out a stroke as the cause of their mother's symptoms. Later, a neurologist diagnosed Nancy with Alzheimer's. Luckily, Kelli insisted on a second opinion. This time, she, her brother, and her mother met with a physician who, like Dr. Gurwitz, took a close look at Nancy's daily medication list before jumping to a diagnosis. Sure enough, some of them had the potential to interact in ways that would lead to the confusion and slurring that had led the Burnses to seek help. But if they hadn't insisted on that second opinion, chances are that rather than re- evaluating Nancy's current roster of medications, doctors would have added even more of them to her list. And who knows how many more problems could have emerged as a result. The fact is, overmedication and misdiagnosis of drug interactions in the elderly is likely even more of an epidemic than Alzheimer's. Making sure you know which medications are most likely to cause problems is one of the best ways to prevent them from occurring in you or your loved ones. In 2003, the Archives of Internal Medicine published a list of medications that were deemed "potentially inappropriate for use in older adults." There are over 75 drugs on that list (to review it, visit http://www.dcri.duke.edu/ccge/curtis/beers.html). But keep in mind that it's been five years since it was updated, so it's still a good idea to schedule an appointment with your doctor -- before any problems emerge -- to go over all of your medications and talk about any potential interactions that could accompany them, as well as interaction-free alternatives you might be able to try instead -- preferably natural ones. And if your doctor isn't willing to help you find safe, natural alternatives to your medications, find a physician who's skilled and knowledgeable in natural medicine who is. For a list of such physicians in your area, contact the American College for Advancement in Medicine at (800)532-3688 or visit www.acam.org. Sources:
"Is grandma drugged up?" CNN (www.cnn.com), 5/29/08
"Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts," Arch Intern Med. 2003; 163: 2,716-2,724 | 
