Nearly two-thirds of Canadian seniors take at least five different prescription medications every day, according to new data from the Canadian Institute for Health Information. The number is even higher among those living in long-term care facilities, where medication use is especially widespread.
The report shows that older adults are frequently prescribed multiple drugs to manage chronic illnesses such as diabetes, high blood pressure, arthritis, and heart disease. Although many of these medications are necessary, experts are increasingly concerned about the risks linked to polypharmacy, which refers to the use of several medications at the same time.
Taking numerous drugs can raise the likelihood of adverse reactions, harmful interactions, and avoidable hospitalizations. In long-term care homes, nearly 90 percent of residents take five or more medications each day, and more than one-third take ten or more. CIHI’s findings also show that the use of antipsychotic and sedative medications remains common, despite national efforts to reduce reliance on these prescriptions.
Health professionals say the findings underline the need for regular medication reviews and stronger coordination between physicians, pharmacists, and caregivers. Many seniors experience what experts call a “prescription cascade,” a situation in which new drugs are prescribed to address side effects caused by others. Advocates for older adults believe Canada’s health system needs to place greater emphasis on deprescribing programs, non-drug therapies, and more holistic approaches to care.
The growing rate of medication use among older Canadians also raises an important question about how well drugs are tested before they reach this population. Many clinical trials exclude people over the age of 65 or restrict participation for those with multiple health conditions. As a result, the medications that seniors rely on every day may not have been studied in people of their age group or in the complex medical circumstances they often face.
Including seniors in clinical research is essential to understanding how drugs actually work in older bodies. Aging affects how the body absorbs, metabolizes, and eliminates medications. Changes in organ function, muscle mass, and body composition can all alter drug effectiveness and safety. Without sufficient evidence drawn from older participants, healthcare providers are often forced to make decisions based on data collected from younger or healthier subjects. This creates uncertainty about proper dosages and the potential risks for seniors who take multiple medications simultaneously.
The issue of representation in clinical trials extends beyond age. “Genetic, metabolic, and environmental differences across populations can significantly influence how patients respond to investigational therapies, especially in rare disease trials,” shares AXIS Clinicals CEO Dinkar Sindhu. Broader participation in trials that include diverse patients and age groups can lead to treatments that are both safer and more effective for the full range of people who will ultimately use them.
Expanding the inclusion of seniors in clinical research would provide clearer guidance for physicians and could reduce the health risks linked to polypharmacy. It would also allow scientists to identify safer drug combinations, refine dosing recommendations, and design treatment plans that reflect the realities of aging populations.
At the same time, stronger medication management programs in clinical settings could help prevent unnecessary prescriptions and improve overall quality of life for older adults. Regular reviews, better communication among care providers, and increased awareness about the dangers of excessive medication use are key steps toward reducing harm.
As Canada’s population continues to age, the challenge of balancing effective treatment with medication safety will become increasingly urgent. Addressing this issue will require collaboration among policymakers, healthcare professionals, and researchers. Clinical trial frameworks must evolve to include older participants, and healthcare systems need to invest in deprescribing initiatives and patient education.
Ensuring that seniors receive medications that are both necessary and properly tested is not just a medical priority but a moral one. The wellbeing and dignity of millions of older Canadians depend on making informed, evidence-based decisions about how drugs are developed, prescribed, and monitored. A more inclusive and responsible approach to medication and research can help Canada move closer to a safer and more compassionate model of care for its aging population.
