Polypharmacy Among Older Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease.

Cohort studyJournal of general internal medicine· Jul 2026

Polypharmacy Among Older Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease.

Melinda Wang, Leena Usman, Benjamin Cho … Jennifer C Lai

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Hospital MedicineCohort studyClinical practiceQ1IF 3.3

Polypharmacy odds triple in adults with MASLD after age 75.

Polypharmacy Among Older Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease.

Melinda Wang … Jennifer C Lai

Journal of general internal medicine · Jul 2026 · Q1 in Internal Medicine

Background

Multimorbidity and polypharmacy are common in older adults with cardiometabolic diseases, but their burden in metabolic dysfunction-associated steatotic liver disease (MASLD) is less understood.

Purpose

To characterize multimorbidity and polypharmacy among older adults with MASLD.

Methods

Adults ≥ 65 years with transient elastography data in NHANES 2017-2020.

Results

polypharmacy odds more than triple in MASLD adults 75 and older

AOR 3.12 (95% CI 2.21 to 4.42)

CI excludes the null - significant

More results

The proportion of women with MASLD decreased with age (55.5 to 39.3%, p = 0.04).

Diabetes, obesity, and cardiometabolic burden were higher in MASLD across all age groups (p < 0.01).

More results

Polypharmacy was most common in MASLD adults ≥ 75 years (60.3%), exceeding younger MASLD adults (36.9%, p = 0.002) and non-MASLD peers (42.7%; p = 0.005).

MASLD adults had higher antidiabetic but lower antihypertensive use (p < 0.05).

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Conclusion · 1 of 3

Older adults with MASLD ≥ 75 years face a significant and independent burden of polypharmacy.

Conclusion · 2 of 3

This challenge is especially salient in MASLD, where aggressive management of cardiometabolic comorbidities is essential to preventing disease progression and non-liver mortality, yet the medications used may heighten geriatric vulnerabilities.

Conclusion · 3 of 3

Age-appropriate medication review, deprescribing, and goal concordant care are critical to navigating this tension in this high-risk population.

Polypharmacy Among Older Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease.

Polypharmacy Among Older Adults with Metabolic Dysfunction-Associated Steatotic Liver Disease.

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