Which medication is listed as potentially inappropriate for older adults?

• A. Aspirin
• B. Metformin
• C. Atorvastatin
• D. Levothyroxine

Answer: (A)

Beers Criteria flags certain medications as potentially inappropriate for older adults because the risks of harm often outweigh the benefits in this population. Aspirin, when used routinely for primary prevention in older adults, is a prime example. The risk of major bleeding—such as gastrointestinal bleeding or intracranial hemorrhage—increases with age, while the expected cardiovascular benefit in people without established cardiovascular disease is not clearly proven. This combination makes aspirin for primary prevention a potentially inappropriate choice for many older patients.

Metformin isn’t automatically inappropriate for older adults; it’s used widely but requires caution if kidney function is reduced. Atorvastatin isn’t inherently inappropriate either; statins may be continued or started based on individual cardiovascular risk, life expectancy, and tolerance. Levothyroxine is a common treatment for hypothyroidism, though dosing needs careful monitoring to avoid overtreatment in the elderly.

So aspirin stands out as the medication most typically listed as potentially inappropriate for older adults in the Beers criteria.