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News
Guidelines have long flagged benzodiazepines, antibiotics for diverticulitis, and aspirin for primary prevention as risky or ineffective in older adults — yet new studies show use remains stubbornly high. Benzo prescriptions among those 65+ have barely budged since 2020, antibiotic use for uncomplicated diverticulitis sits at 97% of VA visits, and over a third of adults 70+ still take aspirin without a clear cardiac history. Medical inertia, ingrained habits, and slow guideline uptake are largely to blame.
Despite decades of warnings, three widely used drug classes continue to be overprescribed to older Americans — and new research shows the gap between guidelines and real-world practice is still wide. Experts point to "medical inertia": clinicians and patients get comfortable with familiar treatments, and updated evidence takes years to filter into everyday care.
Benzodiazepines (think Xanax, Valium, Ambien) prescribed for anxiety and insomnia pose serious risks in older adults — falls, fractures, cognitive impairment, and dependence. While use among those 65+ dipped from 14% to 11.5% between 2015 and 2024, progress has stalled since 2020 and use actually rose among those over 75. Antibiotics for uncomplicated diverticulitis showed no meaningful benefit over pain relief and clear liquids in clinical trials, yet a VA study of 70,000 visits found prescriptions remained at 97% — essentially unchanged despite a decade of guidelines recommending against routine use. And aspirin for primary prevention in adults 70+ has been discouraged since 2019, yet more than a third of that age group still takes it, risking GI and brain bleeding with little proven benefit.
By the Numbers:
Why it matters: Overprescribing in older adults isn't just a clinical inconvenience — it drives falls, hospitalizations, antibiotic resistance, and preventable bleeding events. Closing the gap between evidence and practice requires proactive deprescribing conversations, and patients are encouraged to ask their doctors: "Is this medication still right for me?"
