The Beers Criteria is the plain-English warning label your medicine cabinet never had—and adults 65+ ignore it at their peril.
Story Snapshot
- The American Geriatrics Society lists drugs often risky for adults 65 and older.
- Five clear categories guide when to avoid, adjust, or use with caution.
- High-risk classes include benzodiazepines, sleeping pills, anticholinergics, and some pain relievers.
- An expert panel reviewed more than 1,400 studies to update the 2023 guidance.
What The Beers Criteria Actually Is—and Why It Exists
The American Geriatrics Society publishes the Beers Criteria to flag drugs that are potentially inappropriate for many people 65 and older. The 2023 update states its scope plainly: a list of medications and classes that experts consider risky in older adults due to side effects that rise with age. The aim is not to shame doctors or scare patients. The goal is fewer injuries from medicines that once helped but now harm more than they heal as bodies change.
The criteria target real-world problems: dizziness, confusion, bleeding, falls, and hospital trips that follow a new prescription. The list helps clinicians pause before adding a pill to an already long list. It points out patterns that repeat across millions of visits. That pause matters because age changes how drugs are absorbed, processed, and cleared. What felt safe at 55 can be dangerous at 75, even at the same dose, with the same label.
How The List Is Built—and Why You Should Trust It
An interprofessional expert panel reviewed recent evidence and then approved changes for 2023 using a structured process. The American Geriatrics Society describes five sections so readers can act, not guess: medications to avoid in most older adults, avoid in certain diseases, avoid due to harmful interactions, use with caution, and drugs that need kidney-based dose changes or avoidance. The public guidance makes clear it is about potential inappropriateness, applied with clinical judgment.
The update did not come from one person’s opinion. The society reports that the expert group examined more than 1,400 trials and studies to update the list, which adds weight to the signals clinicians see daily. That broad review helps cut through habit and marketing and puts safety back at the center. It is a common-sense filter: if a drug class regularly causes falls or confusion in older adults, look for another way first.
The Red Flag Drug Classes You Should Recognize
Benzodiazepines such as those for anxiety or sleep can raise risks for falls, memory problems, and car crashes. So can “Z-drugs,” the non-benzodiazepine sleeping pills often pitched as gentler. Anticholinergic medicines, found in many allergy, bladder, and nerve pain products, can cloud thinking and cause constipation and dry mouth. Nonsteroidal anti-inflammatory drugs can increase stomach bleeding and strain kidneys. Aspirin for primary prevention is discouraged in many older adults because bleeding risk often outweighs benefit.
These are not rare edge cases; they are the everyday culprits that fill emergency rooms on weekends. The logic aligns with conservative values and common sense: first, do no harm; second, fix the problem with the least force; third, respect the person’s ability to stay independent. A shorter, safer medication list means fewer falls, clearer mornings, and less time waiting for scans and lab work after a scare.
How To Use The Beers Criteria Without Panic Or Dogma
Start by asking a simple question at your next visit: which of my medicines are on the Beers list, and why am I still on them? That opens a door to right-size doses, switch to safer options, or try non-drug steps. The criteria suggest caution, not blanket bans. Doctors still weigh trade-offs. For some conditions, a risky drug might be the best of bad choices for a short time. The list helps surface that tension early, before trouble starts.
Live Webinar Tomorrow!
Patient Safety in Older Adults: AGS Beers Criteria Overview. The goal of this live webinar is to explain the age-related changes in physiology that alter the effects of medications on older adults.Register Now – https://t.co/ty1k2vqaSh #livece #ce pic.twitter.com/DL8CMHRzpm
— PowerPak (@PowerPakCE) September 28, 2026
Make a plan with guardrails. If you and your clinician keep a Beers-listed drug, set the lowest effective dose, clear stop rules, and a check-in date. Ask about kidney function and drug interactions. Review the full list at least once a year, and any time you add a new prescription. When you see “use with caution,” read that as “prove it helps.” The patient’s goals—walking steady, sleeping well, staying sharp—should lead every decision, not habit or hurry.
Sources:
pmc.ncbi.nlm.nih.gov, my.clevelandclinic.org
