Mark H. Beers, 54, Expert on Drugs Given to Elderly, Dies

Dr. Mark H. Beers, a geriatrician whose seminal research found that some widely used prescription drugs led to harmful and unnecessary side effects in the elderly, died on Feb 28 in Miami Beach. He was 54 and lived in Miami Beach and Fire Island, N.Y.

The cause was complications of diabetes, his family said.

In the 1980s, Dr. Beers and others investigated the use of mood-altering drugs among geriatric patients and concluded that psychoactive medications were probably being too freely prescribed.

With a team from Harvard, he looked at prescriptions and case files for 850 residents of nursing homes around Boston. The researchers found that sedatives, antidepressants and antipsychotic drugs often caused confusion or even physical tremors in patients, who in some cases were not closely supervised by medical staff members. The team’s findings were published in The Journal of the American Medical Association in 1988.

Dr. Beers used the Boston study as groundwork to establish an early list of drugs with known side effects on the elderly. That 1991 list, called Beers Criteria, includes various sedatives, muscle relaxants, antihistamines and antidepressants, and explains their potential for harm. The Beers Criteria were expanded in 2003 and are consulted by nurses, physicians and pharmacists in choosing medications and reviewing patient histories.

Dr. Richard W. Besdine, director of the division of geriatrics at the medical school at Brown University, said Dr. Beers had been an advocate for “thinking three times before picking up the pen to prescribe psychoactive drugs” to elderly patients. Dr. Besdine cited the Beers Criteria and their prescient inclusion of amitriptyline, or Elavil, a common antidepressant and pain medication associated with sedating effects and interference with urination. Lethargy and problems with urination are common complaints in geriatric medicine.

Dr. Besdine, a former president of the American Geriatrics Society, added that Dr. Beers and his fellow researchers made the medical establishment aware of drugs with “side effects far more destructive than any potential therapeutic benefit.”

In 1992, Dr. Beers became an associate editor of “The Merck Manuals,” a series of reference books published by Merck & Company, the international pharmaceutical company, and intended for medical professionals. He was co-editor of “The Merck Manual of Geriatrics” and helped to edit a best-selling 1,900-page compendium intended for a less-specialized readership, “The Merck Manual of Medical Information: Home Edition.”

Mark Howard Beers was born in Brooklyn. He graduated from Tufts before earning his medical degree from the University of Vermont in 1982.

Dr. Beers trained at Harvard and Mount Sinai Hospital before being named an assistant professor of medicine at the University of California, Los Angeles, in 1987. He was also a senior natural scientist at the RAND Corporation from 1989 to 1992.

Dr. Beers is survived by his companion of 33 years, Stephen K. Urice, whom he married in Montreal in 2008; his mother, Linda Beers of West Palm Beach, Fla.; and a sister, Jacqueline Herbsman of Juno Beach, Fla.

A diabetic since childhood, Dr. Beers had parts of both legs amputated in the 1990s. After his operations, he volunteered as a counselor for fellow amputees at Magee Rehabilitation Hospital in Philadelphia. He retired on disability as editor in chief of “The Merck Manuals” in 2006.