Fried TR, Tinetti ME, Towle V et al. Arch Intern Med 2011;171:923–8.
In this study, the authors found that the willingness of older individuals to take preventative medications for cardiovascular disease was relatively insensitive to their benefit, but highly sensitive to their adverse effects.
Guidelines recommend preventative drug therapy for persons at high risk of cardiovascular disease-related events, including older individuals. However, the benefits of preventative drugs are not immediately evident to those who are prescribed them and compliance may be questioned, even though preventative therapy can reduce the risk of myocardial infarction and stroke. In this study, Fried and coworkers observed that older individuals are influenced by the perceived side-effects of the medication, such as fatigue, nausea, or “fuzzy thinking”, to a greater extent than younger individuals. These observations imply that physicians should consider potential side-effects of preventative drugs, at least to the same extent as the expected benefits, when such drugs are prescribed.