title: NSAIDs in the older patient: balancing benefits and harms.
abstract: OBJECTIVE
  The older person is more likely to have pain since degenerative diseases and the effects of cancer are more common after 65 years of age. Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently used due to perceived safety, relatively low cost and over-the-counter availability. This brief review describes the necessity for, but risks of, NSAIDs in the older patient.
  
  
  METHODS
  A literature search was undertaken using PubMed and search terms including pain, aging, treatment, nonsteroidal anti-inflammatory drugs, arthritis, older patient, and guidelines.
  
  
  CONCLUSIONS
  Pain complaints are common in the older population. Low back pain and osteoarthritis affects over two thirds of this group. Patients and clinicians are increasingly wary about treatment since no medication appears to be safe. Older patients opting for no treatment may have worsening function including decreased sleep, mobility, socialization, and increased depression. Ninety percent of all prescription NSAIDs are taken by patients over 65. Guidelines for safe use are available but frequently not followed by the practitioner including the FDA recommended "lowest dose possible for your treatment … for the shortest time needed." NSAIDs can be an effective treatment option for many older persons but caution should be exercised in this often fragile population.
authors.affiliation: University of California, San Diego, San Diego, California, USA.
authors.forename: Bill H
authors.initials: BH
authors.lastname: McCarberg
mesh_terms: D000368:Aged / Q000502:physiology*; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use*; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D040261:Harm Reduction; D006801:Humans; D010003:Osteoarthritis / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy* / Q000517:prevention & control; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Aging; NSAIDs