The study of prescribing for the elderly in the US is in its infancy. Nursing home studies provide some of the most reliable data. In US nursing homes, each resident is prescribed an average of between 7.2 and 8.1 medications, with gastrointestinal agents being the most frequent. The vision for prescribing in the US involves avoidance of polypharmacy and specific groups of medications. Approaches to treatment in the US for certain conditions that can be prevented are addressed, specifically pain control, osteoporosis, stroke, cardiovascular disease, cognitive impairment and infection.