For many, a prescription that helps manage chronic symptoms or disease can be a boon; we’re considered lucky if we have something pharmacologically “treatable.” (As a woman who suffers from a number of ailments doctors have yet to fully understand, a new drug would be preferable to the current response, which is an abashed shrug of the shoulders.)
At the same time, it’s all too easy to accumulate prescriptions, especially as we get older. By midlife, many adults are being treated with blood pressure medications, sleep aids, pain relievers, and prescription antihistamines for the allergies that seem to worsen every year. These medications might make our daily lives a bit more comfortable, but research is showing that taking so many pills can have unanticipated ramifications.
Researchers with the long-running Coronary Artery Risk Development in Young Adults (CARDIA) study at the Duke University School of Medicine recently reported that taking multiple medications may be associated with how strong, mobile and steady you feel, even before “old age” sets in.
Negative Impacts of Polypharmacy Are Felt Earlier Than We Thought
The Duke study was initially funded in 1983 with the goal of identifying factors that begin in young adulthood and might contribute to the development of cardiovascular disease later in life. Starting with a group of over 5,000 young adults, CARDIA has followed participants for over 35 years, making it one of the longest-running studies of its kind.
A news release from the university in August of 2025 noted that “researchers using the long-running CARDIA study looked at data from nearly 2,000 adults, average age 60, and found that nearly 1 in 3 were taking five or more medications — a threshold considered polypharmacy. Those taking five or more prescriptions walked slower, had weaker grip strength, and showed worse balance than peers on fewer medications.”
Evidence that polypharmacy can worsen physical function and increase the risk of falls in the elderly isn’t new or groundbreaking. But the data from the CARDIA study is notable because it shows that the negative impacts start much earlier than previously thought. “What this tells us is that physical decline related to medication use may not be just a problem for people in their 70s or 80s,” lead study author Caroline Sloan, internist at Duke Health and an expert in population health sciences, said in the report. “It could start showing up in your 50s or early 60s, when people still expect to be independent and mobile.”
It’s Not What You’re Taking; It’s ‘How Many’
Results from an additional part of the study suggest that it’s not necessarily the type of drug that matters, either, but the sheer number that makes a difference.
The researchers examined the use of “potentially inappropriate medications” or PIMs, a category defined by the Beers Criteria as “medications that should be avoided in older adults,” which includes heart and anxiety medications along with other drugs. While 25% of participants were taking at least one PIM, use of these medications alone did not independently predict lower physical performance once polypharmacy was accounted for.
“We expected that the specific drugs considered inappropriate for older adults would have the biggest impact,” Sloan said in the release. “But instead, it was really the number of medications that stood out.”
Before You Panic: It’s Not Always a Recipe for Disaster
Although the study concluded that polypharmacy is associated with lower physical function in middle-aged adults, it doesn’t state that it is the sole factor causing that decrease in function. As the study authors wrote in the discussion, “people with more chronic conditions take more medications, so poor physical function may be due to multimorbidity [having multiple diagnoses/conditions] rather than polypharmacy.”
What the researchers want people — particularly primary care physicians — to take away from their findings is the importance of assessing physical performance in patients under 65. The association of polypharmacy and reduced physical function “offers a red flag for clinicians,” Sloan wrote. “If I’m seeing a 58-year-old on 15 medications, that should prompt me to think about their physical function. They may benefit from a physical therapy referral or an exercise program and more broadly, it’s an opportunity to take a closer look at their medication list.”
Top image: Getty Images, via Canva.com
