Frailty and Unintended Risks of Medications

In this narrative review, we focus on aspects of the complicated relationship between frailty and medications that we feel would be of particular interest to researchers and health care practitioners. Frailty and polypharmacy (≥5 medications) are inter-related with evidence of a bidirectional potentially casual relationship. Medication review and withdrawal of potentially inappropriate medications is frequently advised for the management of frailty. Changes in the pharmacokinetics and pharmacodynamics of drugs with frailty are felt to parallel those seen with aging though possibly more pronounced. While both frailty and polypharmacy are associated with adverse outcomes, recent research suggests that relative measures of associated risk may be blunted among older adults with frailty compared to non-frail older adults. Research on drug therapy in later life should include a consideration of frailty and how changes in frailty status may affect the balance between benefit and risk with pharmacotherapy.