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Polypharmacy Among US Older Adults with Limited English Proficiency: 2013-2018
Yimei Wan1, Reshma Ramachandran2,3, K Jane Muir4,5,6
1Yale School of Medicine, New Haven, CT, USA.
Journal of General Internal Medicine
|January 27, 2026
Summary
Older adults with limited English proficiency (LEP) were less likely to use multiple medications (polypharmacy) than English-proficient peers. This may indicate access barriers, not better health outcomes, highlighting the need for language-concordant care.
Area of Science:
- Gerontology
- Health Services Research
- Pharmacology
Background:
- Polypharmacy is prevalent in older adults, linked to adverse health outcomes like frailty and falls.
- Limited English proficiency (LEP) is a growing demographic factor in aging populations.
- The relationship between LEP and polypharmacy in older adults remains understudied.
Purpose of the Study:
- To investigate if older adults with LEP are more or less likely to experience polypharmacy compared to their English-proficient counterparts.
- To examine the association between limited English proficiency and the use of five or more prescription medications in community-dwelling older adults.
Main Methods:
- Cross-sectional analysis of the nationally representative US Medical Expenditure Panel Survey (MEPS) from 2013-2018.
- Inclusion of community-dwelling adults aged 65 and older.
- Definition of polypharmacy as five or more prescription medications and LEP based on self-reported English proficiency and language spoken at home.
- Multivariable logistic regression models adjusted for demographic, socioeconomic, and health factors.
Main Results:
- The study analyzed 50.5 million community-dwelling older adults, with 4.6% identified as having LEP.
- Polypharmacy was less common in older adults with LEP (51.7%) compared to English-proficient older adults (58.1%) in unadjusted analyses.
- After adjusting for covariates, older adults with LEP remained less likely to experience polypharmacy (aOR=0.79, 95% CI 0.67-0.97).
Conclusions:
- Older adults with limited English proficiency demonstrated a lower prevalence of polypharmacy compared to English-proficient individuals.
- This finding may suggest potential barriers to accessing healthcare services for LEP individuals, rather than superior medication management.
- Emphasizes the critical need for culturally and linguistically appropriate interventions to ensure equitable medication access and adherence for diverse older populations.
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