A: One of the most dangerous problems that older adults face is how multiple drugs interact with each other. One quarter of people over 60 take at least three drugs a day. The older they are, the more drugs they take. The more drugs they take, the greater the risk for an adverse reaction that could put them right in the hospital.

A recent study in the Journal of the American Medical Association reported that drug reactions kill an estimated 100,000 people a year in U.S. hospitals. The researchers also claim that another 2.1 million are injured by adverse reactions. The elderly are especially vulnerable because of the multiple prescriptions they take. The federal General Accounting Office reports that more than 5 million Americans use medications that are either inappropriate or could cause adverse interactions serious enough to warrant hospitalization.

So the main message to your mother is that drugs can improve the quality of her life but there are risks for every drug she takes, and the risks grow with every new drug she adds to her daily regimen. The risks can even involve death.

Your mom should also be aware that ads -- no matter what the product -- are meant to sell you into thinking that you want what the seller has to offer. In fact: You need it. Can't live without it. Got to have it. Prescription drugs are no exception. Ever since the Food and Drug Administration eased up on drug companies being able to directly advertise to consumers (they used to just advertise to physicians), the American public has been treated to an orgy of drug ad campaigns. The industry spent $345 million this past year to hawk just one kind of drug -- sleeping pills. Advertising budgets in the pharmaceutical industry are in the billions, causing some to argue that the money could be better spent on research and making drugs more affordable.

In the provocative book, "Selling Sickness," authors Ray Moynihan and Alan Cassels charge that drug companies are marketing their products by recasting health problems as diseases (such as female sexual dysfunction to sell a pink version of Viagra) or redefining conditions so that a greater percentage of the American public will be prescribed their drug. They contend that we're all being persuaded to believe that in some way shape or form -- we're all sick and a pill will make us better. Conditions of irritable bowel syndrome, sleeplessness, social anxiety disorder, erectile dysfunction, restless legs, high cholesterol and attention deficit disorder have become over-medicalized and sensationalized so that drug companies can tout their products to treat them. Moynihan and Cassels call this "disease marketing" and the goal is to medicate as many people as possible. Take for instance Viagra: it was intended to help men with erectile dysfunction caused by medical complications such as from diabetes or spinal cord damage. But its manufacturer, Pfizer, cast a wider net and spent over $300 million showcasing touting younger-looking men and sports stars who suffered from ERD. It paid off with their greatest sales growth to the 18 to 45 age group.

The Prescription Access Litigation Project is a coalition of 118 state, local and national senior, labor and consumer health advocacy groups in 35 states that is fighting to make prescription drugs affordable. It also hands out annual "Bitter Pill" Awards to drug companies it believes have crossed the line in marketing to consumers. Overall, the companies spent $4.65 billion in 2005, advertising brand-name prescription drugs to consumers, which, PAL says, over-promotes drug usage rather than people changing their lifestyles (eating well and exercising) or using less expensive means to get better.

Two of this year's Bitter Pill winners are Lunesta and Ambien CR advertisements that give people the impression, according to PAL Director Alex Sugerman-Brozan, "that a full night's trouble-free sleep is just a pill away, when in fact these drugs don't meaningfully improve how long it takes most people to fall asleep or how long they stay asleep. For many of the millions taking these drugs, changes in behavior would be just as effective, without the side effects. But these ads convince people these drugs are a cure-all." People received coupons for free 7-day trials of Ambien CR without stating what the drug does, and nearly a half billion dollars in advertising was spent by both drug makers to lure Americans into a good night's sleep. The lullaby worked -- 43 million prescriptions were filled for sleeping pills last year alone.

As physician Dr. Jerry Avorn, professor of medicine at Harvard Medical School and author of "Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs" explains, "As a physician, I have seen how the avalanche of direct-to-consumer drug advertising infects the doctor-patient relationship, as patients demand brand-name drugs they've seen promoted in magazines or on television. This aggressive marketing can lead people to take expensive drugs they may not need, driving up costs for consumers and the health care system as a whole."

So, if the statistics on adverse drug reactions doesn't get your mother's attention, perhaps not wanting to merrily follow Pied Piper advertising will stop her short. Prescribing medications, especially to older people with multiple chronic conditions, is complicated and should be entrusted to a physician who knows her medical conditions and can weigh the risks and benefits of her taking a drug. It can be just as powerful walking out of her doctor's office with a prescription telling her to exercise three days a week for 20 minutes a day as taking a pill. It might even be more powerful.