Chinese people over the age of 60 have osteoporosis as high as 56%[1].
But there is one disease that is even more common than it is the foot disease in the elderly, with a prevalence rate of 87%, which seriously threatens the health of our parents [2,3].
However, only 7.3% of people take podiatry seriously and consult a doctor[4].
As the saying goes, “Older feet get older”. As you get older, your legs and feet will start to suffer first.
1. Time is not forgiving
As the age increases, the muscle strength of the foot weakens, the elasticity of the ligament becomes poor, or due to the unsuitable shoes and other reasons, problems such as arch collapse and hallux valgus are prone to occur [1-3 ]. As a result, the weight-bearing capacity of the feet is reduced.
(do it myself)
2. Poor foot care
Old age, poor eyesight, inflexible fingers, and inability to bend down will all lead to a common result-
Forgo foot care.
(do it myself)
Toenails are too long and they are not trimmed, too lazy to wash their feet, etc., which may lead to problems such as toenails that are too long, thickened, and onychomycosis.
The most common foot disorders among older adults are[6]:
Hypertrophic toenails (41.3%)
Hump valgus (commonly known as “big foot”) (28.7%)
Dry skin (26.0%)
corns and calluses (commonly known as “calluses”) (24.0%)
These problems lead to a common consequence-
Unsteady walking and prone to falls.
Many elderly people are overweight, and their feet are heavy when walking, which is prone to pain and increases the risk of falls and fractures.
Also, osteoporosis is a common disease of the elderly, and it is more likely to cause a hip fracture when falling – known as the “last fracture of my life” (the 1-year mortality rate of hip fractures is as high as 22% ~30%, even up to 50%[7-9])
American geriatrician Hazd said: “A clear head and a pair of feet that move freely can make the elderly live better.”[5]
Some time ago, Biden fell three times when he boarded the plane, which confirmed this…
Inappropriate shoes are one of the causes of falls in the elderly, and more than 70% of the elderly have inappropriate shoes[10]. So, what are the main reasons for the inappropriate shoes?
1. The shoes are too narrow
The toes and soles are squeezed for a long time, which will deform the forefoot, causing hallux valgus and deformation of the little toe, which will be very painful.
(do it myself)
2. The shoes are too short
Can bend the toes, which over time can become deformed (ie, hammer toes or claw toes).
(do it myself)
The skin on the dorsum of the foot is squeezed, gradually forming a hard callus, which is painful and swollen.
Elderly diabetics with poor blood sugar control are also prone to serious infections.
A little bit first:
The so-called “shoes for the elderly” should be purchased with caution to avoid paying the “filial piety tax”.
Many “shoes for the elderly” are breathable, wide, soft, non-squeeze, non-slip, and can even be like twisting a towel.
(do it myself)
But in fact, the softer the shoe is, the better. Shoes that can be twisted easily are easily deformed and lack support for the arch of the foot.
When buying shoes for the elderly, follow the principle of “width in front of shoes, tough in mid-shoes, and firm in heels”.
Specifically, the elderly should pay attention to these 3 points when choosing shoes:
1. The sole has a non-slip design
Older people have poorer body balance and reduced ability to sense pressure on the soles of their feet, which increases the risk of falls while walking [5].
So, choose non-slip soles.
Image source: Zhanku Hailuo
2. Hard soles with adequate support
Shoes that are too soft, such as old cloth shoes, lack sufficient support for the arch of the foot, and it is easy to feel uncomfortable when walking too much, with tired, sore and sore feet; Risk of falls [11,12].
Hard sole shoes can increase the safety and stability of the elderly when walking [13].
The mid-section of the shoe should be moderately tough. You can try to twist it by hand. It is not good if it is too easy to twist or can not be twisted at all.
The heel also needs to have a certain height, at least 1.5~2.5cm, to disperse the pressure on the sole of the foot.
Image source: Zhanku Hailuo
3. The upper should be breathable, warm and loose
Older people have poor blood circulation in their feet, and are prone to symptoms such as cold feet, pain, and bruising [11].
Buy a pair of breathable, warm, loose shoes that are comfortable, easy to wear, and reduce the incidence of toenail dystrophy and fungal infection (commonly known as athlete’s foot)[5 ].
It can be a little bigger, leaving about 1 cm in front of the toes,allows enough room for the toes to move.
Image source: Zhanku Hailuo
In addition, there are 3 tips for the elderly when shopping for shoes:
1. It’s best not to buy it on behalf of your children or online, it’s best to try it yourself
Bring your usual socks and insoles. Feel it on your feet and experience walking, running and jumping in the store to choose the most suitable shoes for you.
2. Best to buy in the afternoon
A person’s feet are usually larger in the afternoon than in the morning due to gravity and venous return.
Go to try shoes in the morning, I willWronged the feet of the afternoon [5].
3. Don’t be troublesome, try a few more pairs
Older adults often experience inconsistencies in the size of their feet, such as severe hallux valgus in one foot, or different degrees of collapse in the arches of both feet.
This requires trying several pairs to find a shoe that is comfortable on both feet. Or put arch support pads on a shoe.
This article is definitely suitable for turning to “Dating and Loving a Family”, haven’t you turned it on yet?
Reviewer: Zhao Ran| Attending Physician, M.D., Department of Orthopedics, Peking University Third Hospital
References
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[2]RodguezSaIlz D, TovaruelaCaITi6n N, ¨pezL6pez D, et a1. Foot dis orders in the elderly: a mini. review[J]. Disease. Month, 2 8, 64 (3): 64-91.
[3]Men HB, Dufour AB, Casey VA, et al. F00t pain and mobility limilations in 01der adults: the FKLrrdngh flail fbot study[J]. J Gerontoi A Biol Sci Med Sci, 2013, 68(10): 1281-1285.
[4]ChanHYL, Lee DTF, kungEMF, et al. The effects of a foot and toenail cafe pmtoc01 for older “ults [J]. Ge^alr Nurs, 2012, 33(6): 446-453.
[5] Special book (US). Hazd Geriatric Medicine [M]. Li Xiaoying, translated by Wang Jianye. Beijing: People’s Military Medical Press, 2015: 1645-1659.
[6] Adams C, Athanasoula E, Lee W, et al. Envimnmenta J aIld genetic factors on the development of onychomycosis[J]. J Fungi Basel switz, 2015, l(2): 2ll-216.
[7]Bliuc D, Nguyen ND, Milch VE, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513C21.
[8]Giversen IM. Time trends of mortality after first hip fractures. Osteoporos Int. 2007;18(6):721C32.
[9]Downey C, Kelly M, Quinlan JF. Changing trends in the mortality rate at 1-year post hip fracture—a systematic review. World J Orthop. 2019;10(3) :166C75.
[10]Buldt, A.K. and H.B. Menz, Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. Journal of Foot and Ankle Research, 2018. 11 (1): p. 43-.
[11]L nne T, Olsen H. Decreased capacitance response with age in lower limbs of humans–a potential error in the study of cardiovascular reflexes in ageing. Acta Physiol Scand. 1997 Dec ;161(4):503-7. doi: 10.1046/j.1365-201X.1997.00243.x. PMID: 9429658.
[12]Robbins, S., et al., Foot Position Awareness in Younger and Older Men: The Influence of Footwear Sole Properties. Journal of the American Geriatrics Society, 1997. 45(1): p. 61-66.
[13]Menant, J.C., et al., Effects of Footwear Features on Balance and Stepping in Older People. Gerontology, 2008. 54(1): p. 18-23.