Foot deformities and alterations associated with increased fall risk in older adults

BACKGROUND: Foot alterations have been identified in the literature as a significant risk factor for falls in older adults. However, the contribution of specific types of alterations, such as digital deformities and skin alterations, has not been studied in detail. These findings highlight the importance of improving understanding of podiatric factors that contribute to fall risk. OBJECTIVE: This study aimed to identify which podiatric alterations, such as hyperkeratosis, corns, reduced plantar fat pad, onychomycosis, heel xerosis, and digital deformities, including hallux valgus (HAV), claw toes, supraductus toes, infraductus toes, hammer toes, and quintus varus, are most predictive of fall risk in older adults, both with and without diabetes mellitus. MATERIALS AND METHODS: An analytical, cross-sectional, retrospective study was conducted on 85 individuals over 60 years of age. Foot deformities and dermatological alterations were recorded, and fall risk was assessed using the Tinetti balance and gait scale. Statistical analyses included bivariate tests and binary logistic regression to identify predictors of fall risk. RESULTS: The mean age of participants was 71 years; 66% were women, and 46% had type 2 diabetes mellitus. Overall, 66% of participants had a moderate-to-high risk of falling, and a significant association was observed between fall risk and the presence of diabetes (p = 0.048). Logistic regression analysis revealed that reduced plantar fat pad (p = 0.007) and heel xerosis (p = 0.038) were significantly associated with fall risk, irrespective of the presence of diabetes. CONCLUSION: Podiatric alterations, particularly reduced plantar fat pad and heel xerosis, are strong predictors of fall risk in older adults, irrespective of the presence of diabetes. Foot health assessment should be considered a core component of multidisciplinary fall prevention programmes, reinforcing the crucial role of podiatrists in geriatric care to reduce fall risk.