Systematic Review: Polypharmacy and Risk of Falls Among the Elderly in the Visegrád Group Countries (2015–2025)

Polypharmacy, commonly defined as the concurrent use of five or more medications, is prevalent among older adults due to aging, multimorbidity and the growing complexity of medical treatments. While pharmacological treatment plays an essential role in managing chronic diseases, the use of multiple medications has been associated with adverse outcomes, including increased risk of falls. Falls represent one of the leading causes of morbidity, mortality, and reduced quality of life among the older population. This systematic review examines the relationship between polypharmacy and fall risk among older adults in the Visegrád Group countries, V4 (Poland, Hungary, the Czech Republic, and Slovakia) between 2015 and 2025. Relevant studies were identified through database searches and evaluated according to predefined inclusion criteria. The findings highlight the prevalence of polypharmacy among elderly populations in the region and its association with increased fall risk, particularly when potentially inappropriate medications (PIMs), fall -risk increasing drugs (FRIDs) and drug-drug interactions (DDIs) are involved. The review underscores the necessity for standardized medication reviews and the implementation of deprescribing protocols within V4 healthcare frameworks to foster successful aging and reduce the economic burden of fall-related hospitalizations.