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Comprehensive Fall Prevention Strategies in Elderly: A Systematic Review
Neda Ghasemi, Mohamadhossein Nabian, Hossein Fallah, Morteza Ghasemi, Amirmohamad Najafipour,
Volume 12, Issue 3 (12-2024)
Abstract
Objectives: Falls are one of the leading causes of injury in the elderly; therefore, prevention and early intervention seem essential. Given the importance of examining and identifying factors affecting falls and the lack of such studies, it is essential to conduct this research to investigate the factors influencing falls in older adults in developing countries, with an emphasis on safety and ergonomics.
Methods: A review method was used to conduct this study. Articles from 2019 to 2024 were found using the keywords: "Fall risk factor," "Safety," "Elderly," "Fall prevention," "Home safety," and "Urban safety" on PubMed, Science Direct, and Google Scholar websites.
Results: After a total of 1,154 publications were located, 523 were chosen based on their titles, 120 were examined based on their abstracts, and 51 were chosen whose full texts were available in English. Many elements, including psychological, physical, and cognitive characteristics, ergonomic and safety tools, awareness and education, social factors, and urban services, were examined in the publications about falls among the elderly.
Conclusion: The risk factors for falls in the elderly were taken into account in this study by classifying external variables and internal factors, all of which had an impact on falls in the elderly. The results indicate that few studies have simultaneously assessed multiple factors. Therefore, it is recommended that future studies examine multiple factors concurrently, considering the impact of awareness factors.

Effects of Combined Functional Exercise Training on Cortisol Levels and Quality of Life in Older Adults with Fear of Falling
Masoumeh Seif, Kamal Ranjbar, Mahbanoo Ghaderi,
Volume 14, Issue 1 (3-2026)
Abstract
Objectives: The purpose of this study was to investigate the effects of combined functional exercise training on fear of falling, salivary cortisol levels and quality of life in older adults with fear of falling.
Methods: Forty older adults (16 men and 24 women aged ≥65 years) with fear of falling were randomly assigned to either a control group (n = 20, 8M/12F) or an exercise group (n = 20, 8M/12F). The exercise group participated in an 8-week combined training program consisting of resistance, balance, and flexibility exercises, while the control group maintained their usual lifestyle. Quality of life (LEIPAD questionnaire) and fear of falling (FES-I) were assessed before and 48 hours after the intervention in both groups. Salivary cortisol levels were also measured using the ELISA method.
Results: Fear of falling was significantly lower in the training group compared to the control group after the intervention (p < 0.0001). The 8‑week combined exercise program resulted in a 51% reduction in fear of falling among the older adults (p < 0.0001). Quality of life significantly improved in the training group compared to the control group (p ≤ 0.001). Moreover, salivary cortisol levels were lower in the training group than in the control group (p ≤ 0.0001), while the combined exercises produced a 19.5% reduction in cortisol compared to pre-training levels (p = 0.07).
Conclusion: Combined functional exercise program significantly reduced fear of falling and improved quality of life in older adults, while also inducing a downward trend in cortisol levels. Therefore, such programs can be recommended as safe and effective strategies in geriatric rehabilitation settings
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