Effect of polypharmacy and Fall-Risk-Increasing Drugs (FRIDs) on falls among Brazilian older adults: The SABE cohort study

•The association between polypharmacy and the occurrence of fall, independent of FRID, have not been well explored.•Polypharmacy was not independently associated with the occurrence of fall.•FRID use is associated with the occurrence of fall.•Older adults taking 2 or more FRID had higher odds of fall. Polypharmacy, considered as the use of multiple medications, has been one of the factors associated with a higher risk of falls among older adults. However, the association of this factor regardless of the use of Fall-Risk-Increasing Drugs (FRIDs) has not been extensively explored. Objectives: This study aimed to evaluate the longitudinal association of polypharmacy with falls and verify whether this association is independent of FRID use. Methods: A longitudinal study was conducted with a representative sample of the urban population aged 60 years and over in the city of São Paulo, Brazil, from 2000 to 2006. The analysis of the association among polypharmacy, the use of FRIDs, and the occurrence of falls over the years was performed using Generalized Estimating Equation (GEE) models adjusted for covariates. Results: The association between polypharmacy and falls was significantly attenuated after the adjustment for covariates and FRIDs. Users of two or more FRIDs had higher odds of falls (OR = 1.51; CI [1.16; 1.96]). Conclusion: FRID use was associated with the occurrence of falls among older adults. The number of medications must be kept to the minimum necessary, and FRIDs should be avoided in approaches to preventing falls among older adults.