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Elderly patients with foot pain at increased risk for falls

Patients with severe foot pain have an increased risk for falling compared with those with less intense pain, according to recently published research in Gerontology.

Researchers suggested that this increased risk should make attention to a patient’s foot pain and function a consideration during examination of elderly patients.

Arunima Awale

More than 30% of individuals aged 65 years and older fall at least once a year, a figure that increased to 40% in individuals aged 75 years and older, according to researchers.

“While foot pain has been linked to functional impairments and risk of falls, no studies have evaluated the impact of foot pain on falls in a population-based sample of adults,” Arunima Awale, research associate, Hebrew SeniorLife Institute for Aging Research, Boston, and colleagues wrote. “Furthermore, to our knowledge, only one study has examined the role of dynamic foot function upon falls in older adults.”

To gather more data, Awale and colleagues studied the associations of foot pain, severity of foot pain, foot posture and dynamic foot function with reported falls in 1,375 older adults from the Framingham Foot Study, an observational cohort study of adults to examine the role of foot disorders upon functional limitations and disability.

In the current study, 57% of participants were female, and the mean age was 69 years. Researchers studied the frequency of falls, a patient’s foot posture and foot function.

Awale and colleagues found that compared with patients with no foot pain, those with severe pain (OR = 3.25; 95% CI, 1.65-7.48) or moderate pain (OR = 1.78; 95% CI, 1.06-2.99) had increased odds of two or more falls. In addition, foot pain were 62% more likely to experience recurrent falls. When compared with normal foot posture, those with planus foot posture were 78% more likely to experience two or more falls. Foot function was not associated with falls.

“We know that having more than one fall can be of concern. Many don’t think of feet as the culprit. However, higher odds of recurrent falls were seen for those with foot pain, especially severe foot pain, as well as those with planus foot posture, indicating that both foot pain and foot posture may play a role in falls,” Marian Hannan, DSc, MPH, co-director, Musculoskeletal Research Center at the Institute for Aging Research, said in a press release.

Awale offered suggestions for putting the study’s findings into practice.

“People tend to not think of their feet when they are assessing overall bodily pain and I think that consideration of foot pain should be part of that assessment,” Awale told Healio Family Medicine. “Physicians, many of whom do not include the feet in their clinical exam, may want to inquire about foot issues with their patients as well as consider an examination of the feet. Much of foot pain is treatable, and it may require specialized treatment from a podiatrist or physical therapist to alleviate.” – by Janel Miller

References:

Framingham Heart Study Paper on the Framingham Foot Study (accessed 05-15-17)

Framingham Heart Study webpage on the Framingham Heart Study history (accessed 05-15-17)

Disclosure: The researchers report no relevant financial disclosures.