* Is this illness minor or self-limiting? If so, it may be best to go without drugs.

* Can I get better with lifestyle changes? Losing weight, stopping smoking, curtailing alcohol use and more frequent exercise can all provide substantial benefits, often working as well as - or even better than - prescribed drugs.

* How long has it been since the doctor has reviewed the drugs I am taking? Researchers suggest regularly bagging up all the medicines you’re using (including over-the-counter ones) and taking them to your doctor for a review. Check whether any of the drugs you’re taking can be discontinued.

* Do I need all these drugs? Chances are, the answer is no. Simplifying your drug regimen to include only those that are proven and essential will reduce the risk of drug-induced illness.

* Can the dose be reduced? Challenging your doctor on the dosage and frequency of the prescribed drugs can often result in a reduction, without any loss of benefit.

* What are the adverse effects of this/these drugs? Make sure that your physician has given you a comprehensive list of the potential adverse effects of your medications. Read all the information that comes with a drug so that side-effects are not ignored or wrongly put down to old age.

* Is there a less toxic drug that can do the same thing? There is almost always an alternative medication. Insist on the safest drug possible.

* Should I report this adverse effect? The answer is always yes. Underreporting of adverse drug reactions, or wrongly attributing such symptoms to old age, means that the extent of the problem of polypharmacy will remain largely hidden.

Healthcare in the over-65s rests on the false assumptions that to be old is to be sick and that medicine will cure these problems. To reach your three score and 10, you have a better prospect by looking to your diet and exercise, and saying no to drugs - especially a handful of them.

Pat Thomas