Complementary and Alternative Medicines

Abstract

Older adults are the largest per capita consumers of prescription medications and over-the-counter complementary and alternative medicines in the United States. A recent study identified that older adults are using more drugs than 5 years ago, including drugs newly released on the market as well as dietary supplements, known as complementary and alternative medicines. One study found that about 13% of adults aged 65 years or older used an herbal product within the previous 12 months. Increased use has resulted from increasing evidence supporting the health benefits of dietary supplements, such as omega-3 fish oils, in reducing cardiovascular events. Nahin and colleagues studied the relationship between prescription medications and dietary supplements by analyzing medication use in patients aged 75 years or older enrolled in the Ginkgo Evaluation of Memory (GEM) study. Dietary supplements were defined according to the 1994 Dietary Supplement Health and Education Act and included vitamins, minerals, herbs or other botanicals, and amino acids. In the study, investigators found that 82.5% of patients used at least 1 dietary supplement, and 54.5% used 3 or more. The average number of prescription medications used per patient was 3.5 which was similar to the average number of dietary supplements. The majority (83%) of prescription medication users also used supplements. The most commonly used dietary supplements were a multivitamin; iron; vitamins E, C, D, B, and A; calcium; glucosamine and chondroitin; zinc; magnesium; garlic; ginkgo biloba; saw palmetto; and echinacea. Complementary and alternative medicines are considered dietary supplements. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA), which defined a dietary supplement. Dietary supplements cannot be labeled with health claims but can be labeled with statements of