The Beers Criteria are a valuable tool for clinical care and quality improvement, but may be misinterpreted and implemented in ways that cause unintended harms. In this paper, we describe the intended role of the 2015 AGS Beers Criteria, and provide guidance on how they should be used by patients, clinicians, health systems, and payors. A key theme underlying these recommendations is to use common sense and clinical judgment in applying the 2015 AGS Beers Criteria, and to remain mindful of nuances in the criteria. The criteria serve as a “warning light” to identify medications that have an unfavorable balance of benefits and harms in many older adults, particularly when compared to pharmacologic and non-pharmacologic alternatives. However, there are situations in which use of medications included in the criteria can be appropriate. As such, the 2015 AGS Beers Criteria work best not only when they identify potentially inappropriate medications, but when they educate clinicians and patients about the reasons those medications are included and the situations in which their use may be more or less problematic. The criteria are designed to support, rather than supplant, good clinical judgment.

A case-oriented web-based curriculum in geriatrics was rated favorably by third-year medical students. Students' knowledge increased in key geriatric topics. Student feedback allows for continuous improvement of the curriculum. This model of curricular innovation may be useful for other institutions seeking to develop or enhance geriatric medicine content in the medical school curriculum.

While the PPT 7-item was able to detect differences in mobility between subjects with history of falls and subjects without history of falls in subjects with mild AD, total PPT 7-item score did not predict falling. Gait aid usage was more strongly related to falling in these subjects. Early detection of fall risk in individuals with mild AD is important to prevent injuries and moderate costs of care.

Nursing Homes post-acute care long-term care medications prescribing deprescribing Pharmaceutical agents are a valuable resource to assist in the care of older persons. Their use in post-acute and long-term care settings is particularly notabledfor example, the proportion of nursing home residents taking 9 or more medications increased from 18% in the mid-1990s to 40% less than 15 years later. 1,2 Average drug counts are similarly high around the world, although there is considerable variation in use between settings and countries. 3,4 High medication use occurs despite the fact that persons with advanced age and multimorbidity are particularly susceptible to drug adverse effects due to physiological changes such as declines in hepatic and renal clearance. Further, the probability of deleterious drug interactions rises exponentially as the number of medications increases. 5 Why are so many drugs administered in post-acute and long-term care, and why does the number keep rising? One reason is because new and better agents have been developed for a variety of conditions common in nursing homes, which relieve or prevent morbidity and delay mortality. Many of these newer medications, such as bisphosphonates for fracture prevention, angiotensin-converting enzyme inhibitors for diabetic renal protection, and beta blockers for coronary artery disease, have strong data in the nursing home literature supporting their use. Other reasons for increasing drug lists, however, are less clearly good for patients. In some cases,The authors declare no conflicts of interest.

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