During the last decade explicit criteria are more and more used to evaluate the appropriateness of prescribing in old age. Moreover, evidence is growing that appropriate prescribing is associated with better health outcomes (hospitalization, mortality).  In recent years, also de-prescribing gained attention to tackle the problem of polypharmacy in old age. Extended medication lists  candidate for de-prescribing as well as guidelines on how to communicate de-prescribing with patients are lacking as yet.