Foot and Ankle Risk Factors for Falls in Older People: A Prospective Study

TLDR

Foot problems are common in older adults and are linked to impaired balance and functional ability, yet few prospective studies have examined whether they increase fall risk. The study aimed to determine whether foot and ankle characteristics predict falls in older adults. A prospective cohort of 176 retirees underwent assessments of foot posture, range of motion, strength, deformity, and physiological risk factors, and were followed for 12 months to record falls. Fallers had reduced ankle flexibility, greater hallux valgus, lower plantar sensitivity, weaker toe plantarflexors, and more disabling foot pain, with toe plantarflexor weakness and pain independently predicting falls after adjusting for physiological risk factors and age.

Abstract

Foot problems are common in older people and are associated with impaired balance and functional ability. Few prospective studies, however, have been undertaken to determine whether foot problems are a risk factor for falls.One hundred seventy-six people (56 men and 120 women, mean age 80.1, standard deviation 6.4 years) residing in a retirement village underwent tests of foot and ankle characteristics (including foot posture, range of motion, strength, and deformity) and physiological falls risk factors (including vision, sensation, strength, reaction time, and balance) and were followed for 12 months to determine the incidence of falls.Seventy-one participants (41%) reported falling during the follow-up period. Compared to those who did not fall, fallers exhibited decreased ankle flexibility, more severe hallux valgus deformity, decreased plantar tactile sensitivity, and decreased toe plantarflexor strength; they were also more likely to have disabling foot pain. Discriminant function analysis revealed that decreased toe plantarflexor strength and disabling foot pain were significantly and independently associated with falls after accounting for physiological falls risk factors and age.Foot and ankle problems increase the risk of falls in older people. Interventions to address these factors may hold some promise as a falls prevention strategy.