What Are the AGS Beers Criteria for Older Adults?

What Are the AGS Beers Criteria for Older Adults?

The American Geriatric Society (AGS) is a national nonprofit made up of geriatrics healthcare professionals committed to improving older people’s health, quality of life, and independence.

According to the AGS, in any given month, over 90 percent of older people take at least one prescription medication and over 66 percent take three or more. This has led to one of the organization’s many projects, the AGS Beers Criteria, which is designed to ensure that the medications older people take are appropriate and safe.

The criteria, which target people 65 years old and older in all institutional, acute, and ambulatory care settings, are intended to improve medication selection and the education of patients and healthcare teams, prevent the use of possibly inappropriate medicines, and avoid adverse drug effects and other unintended harm.

What are the AGS Beers Criteria?

The AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, as they’re known in full, comprise a non-exhaustive compendium of medicines to use with caution or to avoid altogether as their risks outweigh their benefits.

The criteria play a pivotal part in aiding older adults, their caregivers, and healthcare providers in working together to make sure older adults are only taking medications appropriate and safe for them. 

Originally developed in 1991 by Dr. Mark Beers, MD, and colleagues, these criteria were most recently updated in 2019.

What do the AGS Beers Criteria say?

The criteria consist of five lists of almost 100 medications that patients should discuss with their healthcare providers before using, as they may be less safe or appropriate than other options. 

The lists outline medicines whose suitability under certain conditions as been brought into question, including medications that:

• most older adults should avoid using,
• older adults with certain health conditions should avoid using,
• older adults should avoid using in combination with certain other forms of treatment due to possible harmful interactions,
• older adults should use with caution due to potential unwanted side effects, and
• older adults with lowered kidney function should avoid or dose differently.

What the AGS Beers Criteria are not

The criteria do not apply to older people who are receiving palliative care or in hospice, nor do they deal with overtreatment or identify every possible case of overprescription.

Furthermore, in its editorial for the updated criteria, the AGS emphasizes that the lists only convey the potential unsuitability of certain medications. The criteria should not be considered as an ultimate authority but rather as factors for healthcare providers, their patients, and those patients’ caregivers to consider when deciding what medications a particular older adult should take and avoid.

Intended to inform policy, research, education, evaluation, and clinical practice to improve the quality of life of older people, the Beers Criteria should not replace professional judgment or supersede a patient’s particular situation, needs, and goals.

What the 2019 updates say

The 2019 AGS Beers Criteria update is based on the work of a panel of 13 experts reviewing over 1,400 studies and clinical trials published between 2015 and 2017. This update identifies:

• 30 classes of medication and individual medications most older adults should avoid,
• 40 classes of medication and individual medications to avoid under certain circumstances,
• 25 classes of medication and individual medications removed from the Beers criteria, and

changes to several previously identified medications to possibly avoid.

Helpful resources

For further study into the benefits and applications of the AGS Beers Criteria, consider these resources:

• The criteria in their entirety, as published in the Journal of the American Geriatrics Society
• Tools to help clinicians recommend the most appropriate medications
• Tools to help older adults and their caregivers understand what makes a medication appropriate or inappropriate

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