Occupational Therapy–Led Home Modifications and Assistive Devices Versus Exercise Programs for Fall Prevention in Community‑Dwelling Older Adults: A Systematic Review

Falls are a leading cause of morbidity, mortality, and functional decline among community‑dwelling older adults. This systematic review synthesizes evidence comparing occupational therapy–led home modifications and assistive devices with structured exercise programs for fall prevention. Nine high‑quality sources—including meta‑analyses, systematic reviews, and practice guidelines—were analyzed. Exercise interventions consistently reduced fall incidence and fall‑related injuries, while occupational therapy approaches enhanced safety, independence, and participation. Multicomponent strategies integrating exercise, environmental adaptations, and vision care demonstrated the strongest overall effectiveness. Assistive technology shows promise but requires further research. Fall‑prevention outcomes are context‑dependent and optimized when interventions are tailored and integrated.