At Mobility and Beyond, we believe that staying strong, safe, and independent starts with understanding your own body—and that includes understanding your medications. Whether you’re managing a chronic condition, recovering from surgery, or simply aging in place, knowing what medications you take and why you take them is essential for maintaining mobility and overall quality of life.
As a Doctor of Physical Therapy with 19 years of experience working with seniors, I’ve seen how medication knowledge—or the lack of it—can profoundly impact balance, strength, safety, and independence. Today, I want to share why medication awareness matters so much and how you can take control of this critical aspect of your health.
The Growing Challenge of Polypharmacy
Let’s start with a sobering statistic: 42% of adults ages 65 and older take five or more medications monthly. This phenomenon, known as polypharmacy, has become increasingly common as we’re living longer with multiple chronic conditions. Polypharmacy is defined as the regular use of 5 or more medications at the same time, which is common in older adults and at-risk younger individuals.
The numbers paint a clear picture of the scope of this issue. Over 70% of people aged over 65 are affected by multimorbidity—having two or more chronic medical conditions simultaneously. A comprehensive systematic review found that polypharmacy is particularly common among older adults and those in inpatient settings, highlighting how medication use tends to accumulate as we age and face more health challenges.
While medications are often necessary and beneficial for managing chronic conditions, the challenge lies in ensuring that each medication serves a clear purpose and doesn’t create more problems than it solves. Research has shown that polypharmacy is associated with the risk of adverse outcomes such as falls, frailty, disability, and mortality in older adults.
How Medications Impact Balance, Strength, and Safety
Many commonly prescribed medications—such as blood pressure medications, pain relievers, muscle relaxants, and sleep aids—can significantly affect balance, coordination, alertness, and muscle strength. Side effects like dizziness, fatigue, or delayed reaction time may increase the risk of falls, especially in older adults.
Falls are one of the leading causes of injury in seniors, and medication-related side effects are often overlooked as contributing factors. Polypharmacy has strong associations with increasing risk of falls, emergency care, and hospitalizations in older adults, all resulting from the complex interactions between multiple medications and age-related changes in how the body processes drugs.
The connection between medications and falls is particularly concerning. The American Geriatrics Society’s has created the Beers Criteria (updated 2023), which is especially helpful for Potentially Inappropriate Medication (PIM) usage in older adults and are widely used by clinicians, educators, researchers, and healthcare administrators to identify medications that may increase fall risk and other adverse outcomes.
What makes this even more challenging is that people over 60 may process medications differently than younger adults. A person over age 60 may have different body composition than someone who is 35 and may metabolize medications at different rates. Additionally, when new drugs are tested before going to market, test subjects may not always include sufficient numbers of older adults, so age-related differences in drug effects aren’t always well understood.
Understanding which medications may impact your mobility allows you, your caregivers, and your healthcare team to take proactive steps—such as adjusting timing, modifying exercises, or making home safety changes—to reduce risk.
The Hidden Danger: Prescription Cascades and Drug Interactions
One particularly insidious problem with polypharmacy is what’s called a “prescription cascade.” This occurs when patients are prescribed additional medications to offset side effects caused by other drugs they’re taking, compounding the risk of polypharmacy. For example, a blood pressure medication might cause swelling in the ankles, leading to a prescription for a diuretic, which might then cause dizziness, leading to yet another medication.
Research has identified that taking multiple prescription drugs raises the risk of drug-drug interactions, in which one medication affects how another works. Studies have shown that polypharmacy is associated with adverse events, drug–drug and disease–drug interactions, and a lower level of adherence to more complex treatment regimens.
Even medications that seem harmless can interact in unexpected ways. Some herbal preparations and nutritional supplements are aggressively marketed to older adults with exaggerated claims and little scientific evidence to back them up. Our patients often add medications purchased over the counter and from online sources, of which healthcare providers are frequently unaware.
Knowledge Empowers Better Healthcare Conversations
When you know the reason you are taking each medication, you’re better equipped to advocate for yourself. You can ask informed questions like:
- Do I still need this medication? And at this dose?
- Could this be affecting my balance or energy?
- Are there alternatives with fewer side effects?
- How does this medication interact with my other medications?
This knowledge is especially important if you’re seeing multiple doctors, as they don’t always communicate with each other about your complete medication regimen. Research shows that medication review (by pharmacists, physicians, or multidisciplinary teams), education and training, and the use of screening tools to identify potentially inappropriate prescribing have all been found to be effective for reducing polypharmacy.
It’s important to understand that if a medication doesn’t work well for you—or causes unwanted side effects—you can and should ask your healthcare provider about alternatives. Many common medication categories, such as antidepressants, blood pressure medications, and blood thinners, have multiple options within them. These medications are not all the same, and what works well for one person may not work for another.
Managing polypharmacy involves understanding what matters most to you, the patient — whether it’s managing a health condition or avoiding intolerable side effects. It’s a highly individualized process that calls for careful listening and candid conversation. Having an open conversation with your provider can help find the option that best fits your body, symptoms, and lifestyle.
Medications and Movement: A Crucial Connection
Physical therapy and movement-based programs work best when medications are properly understood and managed. As both a physical therapist and advocate for healthy aging, I’ve seen how medications and mobility are deeply interconnected:
Pain medications may make exercise more tolerable and enable you to participate in activities that maintain your strength and function. However, they could also mask warning signs that you’re overdoing it or moving in ways that could cause injury.
Blood pressure and heart medications may affect your heart rate and blood pressure response during activity. Understanding these effects helps us adjust exercise intensity appropriately and recognize normal versus concerning responses to physical activity.
Medications that affect balance or cognition require special consideration when planning exercise programs. We need to ensure adequate safety measures are in place and may need to modify certain activities.
Timing matters. For some medications, taking them at specific times relative to exercise sessions can improve both the effectiveness of the medication and the safety and performance during exercise.
At Mobility and Beyond, we take a holistic view—looking at how medications, movement, home setup, and daily routines all interact to support safe and confident mobility. This comprehensive approach has been shown to be most effective. Research indicates that combining home modifications with other interventions produces the best results, including education about fall risks and prevention strategies, exercise programs to improve strength and balance, medication review to identify drugs that increase fall risk, and home modifications to address environmental hazards.
Creating and Maintaining Your Medication List
We encourage everyone—especially older adults and caregivers—to keep an up-to-date medication list. This simple habit can make a powerful difference in your safety and quality of care. Your list should include:
Medication name (both brand name and generic name if you know it)
What it is for (the specific condition or symptom it treats)
How much and how often (exact dosage and timing)
Prescribed by which doctor (especially important if you see multiple providers)
When you started taking it (this helps identify medications that may no longer be necessary)
Any side effects or precautions you’ve noticed or been told about
Bring this list to every medical appointment, therapy session, emergency room visit, and even home safety evaluations. Research shows that high-quality care means reviewing all the patient’s medications at least once a year and after any fall, hospitalization or emergency department visit. Your medication list makes these reviews possible and productive.
Many smartphone apps and online tools can help you maintain this list digitally, making it easy to update and share with healthcare providers. Some pharmacies also provide medication lists and can help you keep them current.
Red Flags: When to Review Your Medications
Certain situations should prompt an immediate medication review with your healthcare provider or pharmacist:
After a fall or near-fall: Research has demonstrated that medications are often a contributing factor to falls. In geriatrics, we teach that when assessing symptoms in patients, think medications first.
When starting a new medication: Ensure your prescriber knows about all your current medications, including over-the-counter drugs and supplements.
If you experience new symptoms: New dizziness, confusion, fatigue, balance problems, or other concerning symptoms may be medication-related.
After hospitalization: Hospital stays often result in medication changes that need to be reviewed and reconciled with your regular regimen.
When you can’t remember what a medication is for: If you don’t know why you’re taking something, it’s time for a review.
If managing your medications feels overwhelming: Complexity itself is a risk factor. A pharmacist intervention study showed that identifying and managing high-risk drugs in patients decreased polypharmacy, with a 67% reduction after the first intervention and 39% after the second.
The Role of Healthcare Professionals in Medication Management
You don’t have to navigate medication management alone. Several healthcare professionals can help:
Pharmacists are medication experts who can review your entire medication regimen, identify potential interactions, suggest alternatives, and answer questions about side effects and timing. Many pharmacies offer comprehensive medication reviews as a service.
Your primary care physician should serve as the quarterback of your healthcare team, coordinating care between specialists and ensuring your overall medication regimen makes sense.
Clinical pharmacists in some healthcare systems can work directly with your doctor to optimize your medications and reduce polypharmacy.
Physical therapists like myself can identify how medications might be affecting your movement, balance, and function, and can communicate concerns to your prescribers.
Research has shown that interprofessional collaboration involving pharmacists, nurses, and geriatricians is critical for effective polypharmacy management. Don’t hesitate to involve these professionals in your medication management.
Deprescribing: Sometimes Less Is More
An increasingly important concept in medication management is “deprescribing”—the systematic process of reducing or stopping medications that may no longer be beneficial or may be causing more harm than good. Deprescribing involves systematically identifying and discontinuing medications where the potential risks outweigh the benefits or where the benefits are unclear. The primary goals are to reduce the adverse effects of polypharmacy and improve medication compliance and clinical outcomes.
Some patients who were prescribed a medication years earlier for a specific condition may continue taking it when it’s no longer necessary. As our health status changes, our medication needs change too. What was appropriate five years ago may not be appropriate now.
The benefits of appropriate deprescribing can include reduced side effects, improved cognitive function, better balance and reduced fall risk, simplified medication regimens that are easier to follow, lower costs, and improved overall quality of life.
Taking Control of Your Medication Health
Understanding your medications isn’t about becoming a medical expert—it’s about being an informed participant in your own healthcare. Every medication you take should have a clear purpose that you understand. You should know what benefits you’re supposed to get from it, what side effects to watch for, and how it fits into your overall health picture.
Aging in place isn’t just about staying at home—it’s about staying informed, empowered, and supported. Your medications are tools to help you maintain your health and independence, but like any tools, they work best when used correctly and purposefully.
Ready to Take Control of Your Medication Health?
At Mobility and Beyond, we work alongside clients and caregivers to help identify factors that may affect safety and mobility, including medication-related concerns. If you have questions about how your medications may be impacting your movement, balance, or confidence, we’re here to help guide the conversation.
Download Our Medication Management Checklist: Get a printable guide to help you organize your medications, prepare questions for your doctor, and identify potential concerns. This practical tool will help you take control of your medication health. Download the Medication Management Checklist
Explore Related Safety Resources: Learn more about fall prevention and home safety strategies in our comprehensive guides on fall prevention for the home and aging in place modifications. View Safety Resources
Schedule a Free Phone Consultation: Concerned about how your medications might be affecting your mobility or balance? Let’s discuss your specific situation during a complimentary 15-minute phone call. I can help you identify questions to ask your healthcare provider and suggest mobility strategies that work with your medication regimen. Click here to schedule
Comprehensive In-Home Assessment: If you live in the western suburbs of Chicago, I offer in-home evaluations that include reviewing how medications might be impacting your functional mobility and safety. Together, we’ll develop strategies to maintain your independence while working safely within your medication regimen. Schedule Your Assessment
Knowledge empowers better health. Understanding your medications is a critical step toward maintaining the mobility, independence, and quality of life you deserve.
