Which client is most at risk for an adverse drug reaction due to polypharmacy?

The individual most at risk for an adverse drug reaction due to polypharmacy is typically the older adult, as they are more likely to be prescribed multiple medications for various chronic conditions. In this case, the 65-year-old with dementia is particularly vulnerable to adverse effects from drugs due to the complex nature of their condition and potential interactions between medications.

Older adults often experience changes in pharmacokinetics—how drugs are absorbed, distributed, metabolized, and excreted—which can heighten the risk of side effects and drug interactions. Dementia patients frequently require medications for both their cognitive symptoms and other comorbidities, increasing the likelihood of polypharmacy. This population also tends to have a more complicated medication regimen, making it challenging to manage and increasing the potential for medication errors and adverse reactions.

While kidney disease, diabetes mellitus, and upper respiratory infections are significant health concerns, the combination of age, the presence of dementia, and the resultant potential for multiple medications creates a high-risk scenario for the 65-year-old.