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Objectives: To investigate the effects of lavender olfactory stimulation intervention on fall incidence in elderly nursing home residents., Design: Randomized placebo-controlled trial., Setting: Three randomly selected nursing homes in northern Japan., Participants: One hundred and forty-five nursing home residents aged 65 and older., Intervention: Participants were randomly assigned to the lavender (n = 73) or placebo group (n = 72) for a 360-day study period. The lavender group received continuous olfactory stimulation from a lavender patch. The placebo group received an unscented patch., Measurement: The primary outcome measure was resident falls. Other measurements taken at baseline and 12 months included functional ability (assessed using the Barthel Index), cognitive function (Mini-Mental State Examination (MMSE)), and behavioral and psychological problems associated with dementia (Cohen-Mansfield Agitation Inventory (CMAI))., Results: There were fewer fallers in the lavender group (n = 26) than in the placebo group (n = 36) (hazard ratio (HR)=0.57, 95% confidence interval (CI) = 0.34-0.95) and a lower incidence rate in the lavender group (1.04 per person-year) than in the placebo group (1.40 per person-year) (incidence rate ratio = 0.51, 95% CI = 0.30-0.88). The lavender group also had a significant decrease in CMAI score (P = .04) from baseline to follow-up in a per protocol analysis., Conclusion: Lavender olfactory stimulation may reduce falls and agitation in elderly nursing home residents; further research is necessary to confirm these findings., (© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.)