LTHOUGH NUMEROUS STUDies have evaluated the patterns and quality of prescription medication use among the elderly, 1-5 information related to the incidence of preventable adverse drug events in the ambulatory geriatric population is limited. Even though most medication errors do not result in injury, 6,7 the extensive use of medications by the geriatric population suggests that sizeable numbers of older persons are affected. The prevalence of prescription medication use among the ambulatory adult population increases with advancing age. A recent national survey of the US noninstitutionalized adult population indicated that more than 90% of persons aged 65 years or older used at least 1 medication per week. 8 More than 40% used 5 or more different medications per week, and Author Affiliations and Financial Disclosures are listed at the end of this article.

SynopsisA standardized, semi-structured interview for examining and recording the mental state in elderly subjects is described. It allows the classification of patients by symptom profile and can demonstrate changes in that profile over time. It is believed that good reliability is demonstrated between psychiatric raters both for psychiatric diagnosis made on the basis of the schedule findings and for individual items. The Geriatric Mental State Schedule (GMS) consists mainly of items from the eighth edition of the PSE (Wing et al. 1967), together with additional items from the PSS (Spitzer et al. 1964), and extra sections dealing with disorientation and other cognitive abnormalities. Modifications have been introduced to facilitate interviewing elderly subjects.

Prevention efforts to reduce ADEs should be targeted toward older adults with multiple medical conditions or taking multiple medications, nonopioid analgesics, anticoagulants, diuretics, and antiseizure medications.