TY - JOUR
T1 - Foot problems in older adults associations with incident falls, frailty syndrome, and sensor-derived gait, balance, and physical activity measures
AU - Muchna, Amy
AU - Najafi, Bijan
AU - Wendel, Christopher S.
AU - Schwenk, Michael
AU - Armstrong, David G
AU - Mohler, Jane
N1 - Funding Information:
Acknowledgment: Arizona Frailty Cohort coordinator Marilyn Gilbert and student workers for the recruitment of participants and the collection of data and the participants for their kind participation. Financial Disclosure: This project was supported in part by award 2R42AG032748 from the National Institute on Aging and by the Arizona Center on Aging. The sponsor had no role in the design or conduct of this study; the collection, management, analysis, or interpretation of the data; or the preparation, review, or approval of the manuscript. Conflict of Interest: None reported.
Publisher Copyright:
© 2019, American Podiatric Medical Association. All rights reserved.
PY - 2018/3
Y1 - 2018/3
N2 - Background: Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults. Methods: Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies. Results: Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) ¼ 2.0], and 95% in frail [OR ¼ 8.3]; P ¼.03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day. Conclusions: Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.
AB - Background: Research on foot problems and frailty is sparse and could advance using wearable sensor–based measures of gait, balance, and physical activity (PA). This study examined the effect of foot problems on the likelihood of falls, frailty syndrome, motor performance, and PA in community-dwelling older adults. Methods: Arizona Frailty Cohort Study participants (community-dwelling adults aged ≥65 years without baseline cognitive deficit, severe movement disorders, or recent stroke) underwent Fried frailty and foot assessment. Gait, balance (bipedal eyes open and eyes closed), and spontaneous PA over 48 hours were measured using validated wearable sensor technologies. Results: Of 117 participants, 41 (35%) were nonfrail, 56 (48%) prefrail, and 20 (17%) frail. Prevalence of foot problems (pain, peripheral neuropathy, or deformity) increased significantly as frailty category worsened (any problem: 63% in nonfrail, 80% in prefrail [odds ratio (OR) ¼ 2.0], and 95% in frail [OR ¼ 8.3]; P ¼.03 for trend) due to associations between foot problems and both weakness and exhaustion. Foot problems were associated with fear of falling but not with fall history or incident falls over 6 months. Foot pain and peripheral neuropathy were associated with lower gait speed and stride length; increased double support time; increased mediolateral sway of center of mass during walking, age adjusted; decreased eyes open sway of center of mass and ankle during quiet standing, age adjusted; and lower percentage walking, percentage standing, and total steps per day. Conclusions: Foot problems were associated with frailty level and decreased motor performance and PA. Wearable technology is a practical way to screen for deterioration in gait, balance, and PA that may be associated with foot problems. Routine assessment and management of foot problems could promote earlier intervention to retain motor performance and manage fear of falling in older adults, which may ultimately improve healthy aging and reduce risk of frailty.
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U2 - 10.7547/15-186
DO - 10.7547/15-186
M3 - Article
C2 - 28853612
AN - SCOPUS:85054461954
SN - 8750-7315
VL - 108
SP - 126
EP - 139
JO - Journal of the American Podiatric Medical Association
JF - Journal of the American Podiatric Medical Association
IS - 2
ER -