Background: Foot problems, including musculoskeletal deformity, peripheral neuropathy, peripheral arterial disease and dermatologic pathology are common in older adults and are associated with increased risk of falling. Multicomponent podiatry interventions have been shown to reduce the incidence of falls.
Aims: To determine the prevalence of foot problems in community-dwelling older adults attending a Falls and Balance Clinic (FBC); podiatry interventions applied; and, associations between foot problems and clinical characteristics.
Methods: Prospective cohort study of patients attending a FBC for Comprehensive Geriatric Assessment. Demographic information was collected; functional, mobility, foot problems and footwear were assessed in clinic.
Results: One-hundred and two patients were included; median age 79.3 [73-84.3] years, 68.6% female, 91.2% residing in their home, 62.7% used a gait aid. Foot problems present in 88.2%: muscle weakness 90.2%, peripheral neuropathy 43.8%, skin or nail pathology 32.4%, peripheral arterial disease 25.5%. Inappropriate footwear was identified in 74.8%. Most patients received footwear education and 50% were prescribed foot and ankle strengthening exercises. Hallux and lesser toe weakness were associated with lower overall balance and mobility scores (p<0.001). Peripheral arterial disease was associated with higher comorbidity (p<0.001) and frailty (p=0.021), and poorer nutrition (p=0.049).
Conclusion: Foot problems are common in community-dwelling older adults attending a falls and balance clinic. Footwear advice is the most common podiatry intervention. Hallux and lesser toe weakness are associated with poorer balance and mobility. Further studies are warranted for optimising footwear and examining the impact of interventions for foot weakness on falls.