Foot and Footwear Considerations for Older People: A Special Article Collection for Gerontology
Year: 2024
Type: editorial
Abstract: This special article collection of Gerontology focuses on a highly prevalent, yet largely neglected issue: foot problems and footwear concerns among older people. Epidemiological studies demonstrate that foot problems are common in this age-group. Up to one in three older people report foot pain [1], and this has a significant detrimental impact on mobility [2], physical function [3], and risk of falls [4]. There is also evidence that foot symptoms increase the risk of early mortality in older people [5]. Clearly, foot problems are consequential and require concerted research attention to improve clinical outcomes [6]. Footwear is also extremely important, as there is good evidence that many older people wear suboptimal footwear [7], and that comfortable and supportive footwear plays a key role in maintaining independence and quality of life in this population [8].Age-related changes in the structure and function of the foot have been previously identified [9] and may be partly responsible for some of these problems. In this article collection, Reeves et al. [10] used 3D scanning technology to characterise the foot shape of 374 women active in court sports divided into 10 year age-groups, and found that older women had a broader, flatter foot and were more likely to have hallux valgus than their younger counterparts. This information will help in the creation of more inclusive athletic footwear designs for older women who participate in sport.This special article collection includes two important papers on the effects of chronic musculoskeletal conditions on foot pain [11, 12]. In older people with rheumatoid arthritis, Stolt et al. [11] report significant lower extremity functional deficits and highlight that many older people report major difficulties in carrying out usual hobbies, performing routine household activities, and putting on shoes/socks. Eltaraboulsi et al. [12] conducted an analysis of the Johnston County Osteoarthritis Project and reported that 4% of the sample developed foot osteoarthritis over a 3 year period, and that 55% with pre-existing foot osteoarthritis demonstrated radiographic progression during that short period of time. Higher body mass index was associated with both increased risk of incident foot osteoarthritis and worse foot and ankle outcome scores, highlighting the importance of maintaining a healthy body weight with advancing age [13].This collection also includes two scoping reviews: one on health promotion models to improve foot health in older people [14], and one focused on the effects of footwear and orthoses on balance [15]. These reviews highlight that simple interventions can be effective in improving footcare behaviours and self-efficacy, and that there is potential for preventing falls if older adults have appropriate footwear. However, substantially more research is needed in both areas to harmonise approaches and address significant gaps in our current understanding.The association between foot problems, footwear, and falls is further explored by two papers [16, 17]. White et al. [16] showed that foot problems were highly prevalent in older people attending a falls and balance clinic, with foot weakness being the most prevalent condition, and three-quarters of the sample wearing inappropriate footwear, potentially placing them at increased risk of falls. The latter study used video capture data, and found that footwear could be a potential contributor to falls in long-term aged care, with socks being particularly hazardous for falling backwards [17].Finally, two studies investigate whether specially designed footwear can improve foot function in older people [18, 19]. Finco et al. [18] used a cross-over design to show that therapeutic footwear was effective in reducing foot pain over a 12 week period, while Futrell et al. [19] showed that although minimally cushioned footwear does not appear to increase the cross-sectional area of intrinsic foot muscles, older people generally reported positive experiences, with self-reported improvements in balance and foot awareness and sensation when these shoes were worn. However, as stated by Soares et al. [20], researchers need to consider the number of steps recorded, as at least 320 steps are required to ensure familiarisation with thin, moderate and thick athletic footwear midsoles prescribed to enhance comfort and support in this population. We hope that readers of Gerontology will find this special issue of interest and useful for their clinical practice, and that older people will benefit from current work in this extremely important but sometimes undervalued field.The authors have no conflicts of interest to declare.This editorial was not supported by any sponsor or funder.H.B.M. and Y.M.G. contributed equally to the conceptualisation and writing of this editorial.
Source: Gerontology
DOI: 10.1159/000542899
Authors: Hylton B. Menz, Yvonne M. Golightly
Language: English
Subfield: Biomedical Engineering
Field: Engineering
Domain: Physical Sciences
Open Access status: bronze
OpenAlex ID: W4405720333