Abstract
Poisoning among older adults poses unique challenges due to age-related physiological changes, polypharmacy, and comorbidities. As Thailand transitions to a super-aged society, this study characterizes poisoning patterns in Thai older adults to inform prevention strategies. This retrospective, cross-sectional study analyzed poisoning cases involving patients ≥ 60 years reported to the Siriraj Poison Control Center from 2020 to 2023. Data included demographics, comorbidities, exposure characteristics, clinical features, and outcomes. Among 5146 poisoning cases, 682 (13.3%) involved older adults (median age: 68.5 years). Females accounted for 50.4%, and the 60-69 age group was most affected (53.8%). Comorbidities, primarily cardiovascular diseases, were present in 58.9% of patients. Most exposures were unintentional (74.6%), with nonpharmaceutical agents (54.2%) slightly exceeding pharmaceuticals (45.8%). Common nonpharmaceutical exposures included venomous animals (15.8%), household products (10.2%), and insecticides or rodenticides (7.4%). The most common scenario for unintentional exposure to nonpharmaceuticals was "accidental ingestion of nonedible substances" (41%). Among pharmaceutical exposures, antipsychotics (12.5%), analgesics (8.4%), and cardiovascular agents (5.3%) were most frequent. Unintentional pharmaceutical poisonings (73%) often resulted from adverse drug reactions or interactions (56.8%) or wrong administration route (20.8%). The proportion of fatal cases declined from 2020 to 2023; however, this trend should be interpreted cautiously due to potential confounding factors. Overall, poisoning in Thai older adults is primarily unintentional and often linked to complex medication use and comorbid conditions. These descriptive findings provide baseline information to support future efforts in medication safety, environmental awareness, and mental health promotion for Thailand's aging population.