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Watch Out: Statins in old people? Maybe. Maybe not

The fastest-growing demographic group (at least percentage-wise) in North America is the old old, that is people over the age of 75.

This is also the cohort with the highest rate of complex chronic medical conditions.

And this is also the group that takes the most drugs, often several, sometimes many, for their many health problems.

And this is the group that is most sensitive to drug reactions and interactions.

And its also the group in whom the immune system (and others) is slowly (sometimes quickly) fading so side effects and complications form inappropriate drug use are most numerous among them.

So you would naturally think that this is the part of the population that would have been studied most about what the many drugs they have to take do to these people’s health, especially, I suppose, drugs that are not meant to treat something they have but rather to prevent something they don’t have yet, which makes such “preventive” drugs more of an add-on than a must-have.

Well, this age-group hasn’t been studied much, and in fact, we know next to nothing about what happens with many (most?) widely-used drugs in this most vulnerable population.

Take statins, for example, which surveys tells us, millions and millions of 75-year-olds and up are taking to – in theory – prevent heart attacks and strokes.

So it’s chastening to read the conclusion from a recent analysis by an expert panel  convened by the (US) National Institute on Aging and the National Heart, Lung and Blood Institute and which was published in the Journal of the American Geriatric Society.

The authors write: “There is insufficient evidence regarding the benefits and harms of statins in older adults, especially those with concomitant frailty, polypharmacy (taking lots of drugs), comorbidities (suffering several chronic conditions), and cognitive impairment; a lack of tools to assess (cardiovascular) risk in those aged 80 and older; and a paucity of evidence of the effect of statins on outcomes of importance to older adults.”

That last sentence is a show-stopper: In other words, we know next-to-nothing about the effects of statins in the elderly.

But we continue to flood them with drugs because in theory, the drugs might help.

Which should always bring back the wise words of our generation’s most brilliant philosopher, Homer Simpson. “In theory,” says Homer, “Communism works.”

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