Beers Criteria: What It Is and Why It Matters for Older Adults on Medications

When you’re over 65, your body processes drugs differently. What worked fine at 40 might now cause falls, confusion, or even hospitalization. That’s where the Beers Criteria, a list of medications that pose higher risks for older adults, updated regularly by the American Geriatrics Society. Also known as the Beers List, it’s a practical tool used by doctors, pharmacists, and caregivers to cut down on harmful prescriptions. It’s not a ban—it’s a warning. Some drugs on the list are fine for short-term use or if no alternatives exist, but they should never be prescribed blindly.

The polypharmacy, the use of multiple medications at once, common in seniors with several chronic conditions is one of the biggest problems the Beers Criteria fights. Take an older person on blood pressure meds, painkillers, sleep aids, and antidepressants—all approved individually. Together, they can slow breathing, mess with balance, or trigger delirium. The inappropriate drugs in seniors, medications flagged by the Beers Criteria for their high risk in older populations include things like benzodiazepines for insomnia, anticholinergics for overactive bladder, and certain NSAIDs for arthritis. These aren’t just side effects—they’re preventable emergencies.

The list keeps changing. Every few years, experts review new data and remove drugs that are now safer or add ones that were overlooked. For example, diphenhydramine (Benadryl) has been on the list for years because it causes drowsiness and memory issues in older people. Yet it’s still sold over the counter, and many seniors take it without knowing the risk. The same goes for long-acting sulfonylureas like chlorpropamide—used for diabetes but linked to dangerous low blood sugar. The Beers Criteria doesn’t just name bad drugs; it points to better ones. Instead of diphenhydramine, melatonin or behavioral sleep fixes are safer. Instead of meperidine for pain, acetaminophen or low-dose opioids with close monitoring work better.

If you or a loved one is on three or more prescriptions, ask: Are any of these on the Beers List? Can any be stopped? Is there a simpler, safer option? This isn’t about cutting meds—it’s about choosing smarter ones. The posts below dig into real cases: how a common sleep aid led to a fall, why an antihistamine worsened dementia, and how switching from one drug to another cut hospital visits. You’ll find guides on reading drug labels, spotting hidden risks in over-the-counter pills, and how to talk to your doctor without sounding skeptical. This isn’t theoretical. These are the mistakes happening right now—and the fixes that actually work.