ABSTRACT Background While fans are recommended for cooling at temperatures ≤ 40°C, the extent to which ceiling fans mitigate perceptual and physiological strain in older adults exposed to warm indoor environments (~31°C 87.8°F) remains unclear. Methods This follow‐up analysis of our randomized study used validated questionnaires to evaluate effects of ceiling fans on self‐reported heat‐related symptoms (68‐item Environmental Symptoms Questionnaire; ESQ‐IV) and mood‐state (40‐item Profile of Mood States questionnaire; POMS‐40) in bed‐resting older adults during indoor overheating (8 h; 31°C (87.8°F), 45% relative humidity). Twenty participants (median age interquartile range: 71 68–73 years; 12 females) completed two sessions with a ceiling fan set to 0 m/s (control) or ~1.5 m/s (fan). Perceptual outcomes (ESQ‐IV, POMS‐40) were assessed pre‐exposure and at end heating. Cumulative physiological strain was assessed using area‐under‐the‐curve (AUC) values for core temperature and heart rate over hours 0–8. End heating perceptual scores were evaluated using linear mixed‐effects models adjusted for pre‐exposure scores and fan condition (with/without each physiological strain index). Results Core temperature and heart rate increased 0.15 0.06, 0.24°C (0.27 0.11, 0.43°F; p = 0.003), and 1.5 0.5, 3.4 bpm ( p = 0.135) per hour, respectively, with no‐fan compared with fan use. After adjusting for core temperature AUC ( p = 0.233), total symptom scores were 1.3‐fold 1.1, 1.7 higher with no‐fan ( p = 0.015). Heart rate AUC did not modify this effect ( p = 0.215); however, greater heart rate AUC was independently associated with higher symptom scores ( p = 0.042). Mood disturbance did not differ between fan conditions and was not significantly associated with physiological strain markers (all p ≥ 0.187). Conclusions Ceiling fans alone do not fully mitigate perceptual or physiological strain in older adults exposed to prolonged indoor overheating. Nonetheless, a “fan‐first” strategy integrating fan use with ambient cooling may offer an accessible, energy‐efficient approach to enhance heat‐health protection in this population. Trial Registration: ClinicalTrials.gov identifier: NCT06142890
McGarr et al. (2026) studied this question.