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Polypharmacy and frailty among aging World Trade Center responders
Chinmayi Venkatram1, Fred Ko2,3, Ghalib Bello4
1Department of Medical Education, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America.
Plos One
|December 4, 2025
Summary
Polypharmacy and fall-risk increasing drug use are common in aging World Trade Center (WTC) responders. Optimizing medication management is crucial for healthy aging in this population exposed to environmental hazards.
Area of Science:
- Environmental Health
- Gerontology
- Clinical Pharmacy
Background:
- World Trade Center (WTC) responders faced environmental hazards during 9/11 recovery efforts.
- These exposures may accelerate aging and increase frailty in this population.
- Understanding medication risks is vital for WTC responders' long-term health.
Purpose of the Study:
- To examine the relationship between polypharmacy and frailty in aging WTC responders.
- To identify factors associated with polypharmacy and fall-risk increasing drug (FRID) use.
- To inform strategies for mitigating medication-related risks in this cohort.
Main Methods:
- Study included WTC responders aged 50+ from 2017-2019 WTC Health Program data.
- Frailty assessed using WTC-specific Clinical Frailty Index.
- Multivariable logistic regression analyzed associations with polypharmacy (≥5 medications) and FRID use, adjusting for covariates.
Main Results:
- 55% of 6,966 WTC responders had polypharmacy; 7.6% used FRIDs.
- Frailty was independently associated with polypharmacy (OR 1.15) and FRID use (OR 1.11).
- Older age, obesity, protective service jobs, GERD, obstructive airway disease, and upper respiratory disease linked to higher polypharmacy odds. Female sex, smoking, anxiety, depression, and PTSD linked to higher FRID use odds.
Conclusions:
- High prevalence of polypharmacy and FRID use observed in aging WTC responders.
- Frailty is significantly associated with both polypharmacy and FRID use.
- Optimizing medication management is essential for promoting healthy aging in WTC responders.
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