Tehran University of Medical Sciences Auditory and Vestibular Research 2423-480X 0 0 2026 08 01 1570 1570 EN fateme kazemi 0009-0002-1689-3969 parisa Jalilzadeh Afshari 0000-0002-7644-2492 Saeideh Mehrkian - Mohammad Hassan Azarsa 0000-0001-9321-0450 Enayatollah Bakhshi 0000-0001-6566-9723 2026 05 10 2026 07 25 Background and Aim: Falls in older adults are a major clinical and public health issue, often linked to dizziness and vestibular dysfunction. Changes in verticality perception, visual dependence, and postural control can increase fall risk. This study compared vestibular–perceptual and and postural control characteristics using a virtual reality system between older adults with and without dizziness-related falls. Methods: We enrolled 66 older adults in a fall group (n = 33) or a control group (n = 33) based on dizziness-related falls. All participants met the same criteria for cognitive status, sensory function, psychological health, medical stability, and vestibular integrity. We assessed static and dynamic subjective visual vertical (SVV) and used a virtual reality reaching task to measure postural control. Participants also completed self-reported dizziness-related disability and fear of falling measures. We compared groups and ran regression analyses, controlling for age. Results: Compared to controls, older adults with falls showed greater deviations in static and dynamic SVV and higher visual dependence (p < 0.05). The fall group also had reduced center-of-pressure displacement and trunk excursion during the virtual reaching task. Dizziness-related disability and fear of falling correlated with vestibular–perceptual and postural measures. Conclusion: Older adults who experience dizziness-related falls exhibit impaired verticality perception, greater reliance on visual cues, and altered postural control. These findings underscore the value of vestibular–perceptual assessments and virtual reality tasks for identifying fall risk and guiding targeted rehabilitation for older adults. https://avr.tums.ac.ir/index.php/avr/article/view/1570 https://avr.tums.ac.ir/index.php/avr/article/download/1570/696