What Is the Beers Criteria and Why It Matters for Older Adults…

By AB Consulting PharmD

What Is the Beers Criteria and Why It Matters for Older Adults…

When it comes to prescribing medications for older adults, one size does not fit all. As we age, our bodies change in ways that can make certain drugs less effective—or even dangerous. That’s why pharmacists and healthcare providers rely on tools like the Beers Criteria, a trusted guide for identifying potentially inappropriate medications in older adults.

What Is the Beers Criteria?

The Beers Criteria, first developed in 1991 by Dr. Mark Beers, is a list of medications that may pose more risks than benefits in people aged 65 and older. It is maintained and regularly updated by the American Geriatrics Society (AGS) to reflect the latest evidence in geriatric pharmacotherapy.

This list doesn’t mean the medications are never appropriate, but it does flag them as potentially risky due to increased side effects, drug interactions, or poor outcomes in seniors. Common concerns include:

  • Increased fall risk  
  • Cognitive impairment  
  • Kidney or liver sensitivity  
  • Poor medication clearance  
  • Greater sensitivity to side effects

What’s New in the 2023 Update?

The 2023 AGS Beers Criteria® update brought several important changes, refining the guidance for healthcare professionals. Here are a few highlights:

  1. New Medications Added: Several newer drugs were evaluated and included in the criteria due to emerging data showing increased risk in older adults.  
  2. Changes in Recommendations: Some medications were removed or had their risk classifications updated based on new evidence or changes in prescribing trends.  
  3. Focus on Drug-Drug Interactions and Deprescribing: The update emphasized the importance of reviewing combinations of medications that can amplify risks, such as drugs that prolong the QT interval or increase bleeding risk.

A key takeaway? Medication reviews should be ongoing, not one-time events. A medication that was right five years ago may not be safe today.

Why This Matters for Your Loved Ones

Polypharmacy—taking multiple medications at once—is common in older adults, especially those managing chronic conditions. But too many prescriptions can increase the risk of falls, confusion, hospitalization, and even early mortality.

The Beers Criteria is a powerful tool we use at AB Consulting PharmD during our medication therapy management sessions to:

  • Screen for inappropriate or high-risk medications
  • Discuss safer alternatives with patients and prescribers
  • Support deprescribing when medications are no longer needed
  • Reduce adverse drug events and improve quality of life

Final Thought: