Aims: This study examines exposure to anticholinergic and sedative (AS) medications in the general aging population using the Drug Burden Index (DBI) and to analyze the association of AS burden with vertigo, dizziness and balance problems (VDB, primary outcome) and falls (secondary outcome).Methods: We performed a cross-sectional analysis of data from the second follow-up (FF4) in 2013/14 of the Cooperative Health Research in the Region of Augsburg (KORA)-S4 study. AS burden was classified as DBI > 0. Self-reported data of VDB and falls during the previous 12 months were collected. Multivariable logistic regression was used to estimate the association of AS burden with VDB and falls.Results: 883 participants were included in this study (mean age 73.8 years, 48.4% female). AS burden was present in 167 (18.9%) participants, with the highest prevalence in those aged >= 80 years old (26.3%). In the adjusted analysis, AS burden was independently and significantly associated with VDB (Adjusted Odds Ratio (AOR): 1.73 [95% CI: 1.16, 2.56]).Conclusion: This study provides reliable prevalence estimates of AS burden in older people using the DBI in Germany, also indicating a positive and significant association with VDB. As VDB are among the main reasons for falls, we do recommend including the AS burden calculation as routine risk assessment in ambulatory medical care.