The American Geriatrics Society (AGS) has released a significant update to its widely used AGS Beers Criteria, providing comprehensive alternatives to potentially harmful medications commonly prescribed to older adults. Published in the Journal of the American Geriatrics Society, the update includes both safer pharmacologic substitutes and effective non-pharmacologic treatments, marking a major step toward improving medication safety in geriatric care.
The AGS Beers Criteria® identifies medications that are considered potentially inappropriate for older adults due to risks such as sedation, falls, delirium, and adverse drug interactions. The updated resource expands on this by offering actionable alternatives, structured in user-friendly tables organized by symptom or diagnosis. The effort was led by a 19-member multidisciplinary panel from 14 states, including physicians, pharmacists, nurses, psychologists, and physical therapists. Among them, Dr. Noll Campbell from the Regenstrief Institute was the sole expert representing Indiana.
Panelists were assigned to eight topic-specific workgroups covering insomnia and anxiety; allergy and pruritus (itchy skin); cardiovascular and anticoagulation therapies; pain; delirium and dementia; diabetes; gastrointestinal syndromes; and genitourinary syndromes. These were distilled into a detailed table of safer options for 21 common geriatric conditions. The recommendations include behavioral and lifestyle changes such as cognitive behavioral therapy for insomnia, exercise for Parkinson’s disease, and dietary modifications for constipation or heartburn.
Importantly, the update introduces patient-friendly materials like decision aids and deprescribing handouts, reinforcing a modern, team-based and patient-centered approach to care.
"We recognize that simply removing a medication may not be enough, especially if symptoms return or worsen,” said Dr. Campbell. "Our intent is to provide practical, prioritized alternatives that can be started or considered right away, so that care is both safer and responsive to what matters most to older adults and their caregivers. We want clinicians to have real tools, not just warnings."
Reference: American Geriatrics Society Beers Criteria® Alternatives Panel, Steinman, M. A., Semla, T. P., Akgün, K. M., Alessi, C. A., Beizer, J. L., ... & Steinman, M. A. (2025). Alternative Treatments to Selected Medications in the 2023 American Geriatrics Society Beers Criteria®. Journal of the American Geriatrics Society.
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