Fractures & falling

Foot problems


LASA185

Contact: Natasja van Schoor

 

Background
Foot problems, including painful and deformed feet, toenail problems, infections, ulcers and corns, are an extremely common problem in older persons.1,2,3 Menz and Lord 4 reported that 87% of a sample with community dwelling elderly reported at least one foot problem. Munro and Steele 2 found that 71% of independently living elderly of 65 years and older reported suffering from foot problems. The prevalence and severity of foot conditions increase with age, as the aging process can result in neuropathy and ischemia.3 In addition, chronic conditions such as diabetes, peripheral vascular disease, and arthritis often cause disorders of the feet.3 Foot problems are associated with impaired balance and physical performance,4 and may increase the risk of falls,5 and foot fractures.6

 

Measurement instruments in LASA
Foot problems were assessed during the face-to-face medical interview of LASA-C, -D, -E and -F. During the interviews at LASA-C and LASA-D, interviewers were instructed to inspect both feet and to score whether the feet were intact (yes/no). When one of the feet was not intact, the interviewer classified abnormalities as: sores, corns, crooked grown toes, amputation of toes, amputation (of part) of the foot, or any other foot problem. In addition, the interviewer observed whether the respondent had a smack feet and whether the respondent was able to pull up his/her toes, and. In LASA-E and-F, inspection of the feet was not performed, only the last observation whether the respondent was able to pull up his/her toes was done.

Questionnaires
LASAC185 / LASAD185 / LASAE185 / LASAF185 (medical interview, in Dutch)

Variable information
LASAC185 / LASAD185 / LASAE185 / LASAF185
(pdf)

Availability of information per wave1: 

 

B

C

D

E


2B*

F

G

H



3B*

MB*

I*

Foot problems

Me

Me

Me 

-

Me

-

-

-

-

1 More information about the LASA data collection waves is available on:
http://www.lasa-vu.nl/data/lasa/sampleLASAdatacollection.html

 * 2B=baseline second cohort;
    3B=baseline third cohort;
    MB=migrants: baseline first cohort (Under Construction)
    I=Under Construction

Me=data collected in medical interview

Previous use in LASA
Foot problems have been studied as predictor for falls in three studies (Pluijm et al. 2012; Stel et al. 2003; Tromp et al. 2001). According to pre-defined criteria, it was decided that only predictors with a prevalence of 10% or more were evaluated. Therefore, only the observation whether the foot was whole or not (any foot problem) was examined as a potential predictor. However, any foot problem was no predictor in these risk profiles. In addition, Pijper et al. (2012) included foot problems as covariable, exploring the association between diabetes and recurrent falls.

  • Pijpers, E, Ferreira, I, De Jongh, RT, Deeg, DJH, Lips, PTA, Stehouwer, CDA, Nieuwenhuijzen Kruseman, AC. Older individuals with diabetes have an increased risk of recurrent falls: analysis of potential mediating factors: the Longitudinal Ageing Study Amsterdam. Age Ageing 2012; 41, 358-365.
  • Pluijm SMF, Smit JH, Tromp AM, Stel VS, Deeg DJH, Bouter LM, Lips, PTA. . A risk profile for identifying community-dwelling elderly with a high risk for recurrent falling: results of a three year prospective study. Osteoporos Int 2006;17:417-425.
  • Stel VS, Pluijm SMF, Deeg DJH, Smit JH, Bouter LM, Lips P. A classification tree for predicting recurrent falling in community-dwelling older persons. J Am Geriatr Soc 2003;51:1356-1364.
  • Tromp AM, Pluijm SMF, Smit JH, Deeg DJH, Bouter LM, Lips P. Fall-risk screening test: a prospective study on predictors for falls in community-dwelling elderly. J Clin Epidemiol  2001;54:837-44.

References

  1. Menz HB, Lord SR. Foot problems, functional impairment, and falls in older people. J Am Podiatr Med Assoc 1999;89:458-67.
  2. Munro BJ, Steele JR. Foot-care awareness. A survey of persons aged 65 years and older. J Am Podiatr Med Assoc 1998;88:242-8.
  3. Robbins JM. Recognizing, treating, and preventing common foot problems. Cleve Clin J Med 2000;67:45-7, 51-2, 55-6.
  4. Menz HB, Lord SR. The contribution of foot problems to mobility impairment and falls in community-dwelling older people. J Am Geriatr Soc 2001;49:1651-6.
  5. Tinetti ME, Speechley M, Ginter SF. Risk factors for falls among elderly persons living in the community. N Engl J Med 1988;319:1701-7.
  6. Keegan TH, Kelsey JL, Sidney S, Quesenberry CP Jr. Foot problems as risk factors of fractures. Am J Epidemiol 2002;155:926-31.