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Chapter 45 - Foot Health

from Section III - Care of the Elderly by Organ System

Published online by Cambridge University Press:  30 June 2022

By
Diana Homeier  and
Araz Melkonian
Edited by
Jan Busby-Whitehead ,
Samuel C. Durso ,
Christine Arenson ,
Rebecca Elon ,
Mary H. Palmer  and
William Reichel
Jan Busby-Whitehead
Affiliation:
University of North Carolina, Chapel Hill
Samuel C. Durso
Affiliation:
The Johns Hopkins University, Maryland
Christine Arenson
Affiliation:
Thomas Jefferson University, Philadelphia
Rebecca Elon
Affiliation:
The Johns Hopkins University School of Medicine
Mary H. Palmer
Affiliation:
University of North Carolina, Chapel Hill
William Reichel
Affiliation:
Georgetown University Medical Center
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Summary

For older adults, foot problems can significantly affect mobility, function, and quality of life. Because the foot can impact overall function, the podiatric exam for either preventive or problem-related issues is an important part of geriatric care. The foot exam begins with the shoes and then includes a dermatologic, musculoskeletal, vascular, neurologic, and functional assessment. Common skin and nail conditions include hyperkeratotic lesions, ulcerations, tinea pedis, and onychomycosis. Forefoot conditions include hallux valgus (bunion), hallux limitus, hallux rigitus, digiti flexus (hammertoe), sesamoiditis, fractures, and Mortons’ neuroma (intermetatarsal neuroma). Midfoot conditions include pes planus and posterior tibial tendon dysfunction. Common heel conditions include plantar fasciitis, heel pad syndrome, Achilles tendinitis, and tarsal tunnel syndrome. Systemic disease such as diabetes and gout can also affect the foot. Treatment modalities for foot conditions can include topical, injected, or oral medications, pads or orthotics, and surgical correction. Health-care practitioners are encouraged to examine the feet of their older patients and provide education about foot care and footwear.

Keywords

foot healthfoot disordersfoot examinationagingquality of lifefalls
Type
Chapter
Information
Reichel's Care of the Elderly
Clinical Aspects of Aging
 , pp. 558 - 568
Publisher: Cambridge University Press
Print publication year: 2022

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References

Thomas, MJ, Roddy, E, Zhang, W, et al. The population prevalence of foot and ankle pain in middle and old age: A systematic review. Pain. 2011; 152:2870.Google Scholar
Stubbs, B, Binnekade, T, Eggermont, L, Sepehry, AA, et al. Pain and risk for falls in community dwelling older adults: Systematic review and meta-analysis. Archives of Physical Medicine and Rehabilitation. 2014; 95:175–187.Google Scholar
Stults, BM. Preventive health care for the elderly in personal health maintenance. West J Med. 1984; 141:832–845.Google Scholar
Helfand, AE, Robbins, JM. Foot problems. In: Halter, JB, Ouslander, JG, Studenski, S, High, KP, Asthana, S, Supiano, MA, Ritchie, C, eds. Hazzard’s Geriatric Medicine and Gerontology, 7th edition. New York: McGraw Hill Education Medical, 2017.Google Scholar
Menz, HB. Physiological changes in the ageing foot. In: Foot Problems in Older People: Assessment and Management. Edinburgh: Churchill Livingstone/Elsevier, 2008.Google Scholar
Eckles, R. Disorders of the foot. In: Harper, GM, Lyons, WL, Potter, JF, eds. Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine, 10th ed. New York: American Geriatrics Society, 2019.Google Scholar
Alexander, IJ. The Foot Examination and Diagnosis, 2nd ed. New York: Churchill Livingstone, 1997.Google Scholar
Menz, HB. Assessment in foot problems. In: Older People: Assessment and Management. Edinburgh: Churchill Livingstone/Elsevier, 2008.Google Scholar
Grant-Kels, JM. Dermatologic diseases and disorders. In: Harper, GM, Lyons, WL, Potter, JF, eds. Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine, 10th edition. New York: American Geriatrics Society, 2019.Google Scholar
Becker, BA, Childress, MA. Common foot problems: Over the counter treatments and home care. Am Fam Physician. 2018; 98950:298–303.Google Scholar
Helfand, AE. Foot problems. In: Evans, J, Williams, T, eds. Oxford Textbook of Geriatric Medicine, 2nd edition. Oxford: Oxford University Press, 2000.Google Scholar
Helfand, AE, Robbins, JM. Foot problems. In: Ham, R, Sloane, P, eds. Ham’s Primary Care Geriatrics: A Case-Based Approach, 6th edition. Philadelphia, PA: Saunders, an imprint of Elsevier, 2014.Google Scholar
Hashmi, F, Nester, CJ, Wright, CRF, Lam, S. The evaluation of three treatments for plantar callus: A three armed randomized, comparative trial using biophysical outcome measures. Trials. 2016; 17:251.CrossRefGoogle Scholar
Goldstein, BG, Goldstein, AO, Morris-Jones, R. Cutaneous warts (common, plantar, and flat warts). September 19, 2019. www.uptodate.com/contents/cutaneous-warts-common-plantar-and-flat-warts?search=plantar%20warts&source=search_result&selectedTitle=1~95&usage_type=default&display_rank=1.Google Scholar
Peterson, MJ, Approach to the differential diagnosis of leg ulcers. UpToDate. May 2020. www.uptodate.com/contents/approach-to-the-differential-diagnosis-of-leg-ulcers?search=foot%20ulcers&source=search_result&selectedTitle=2~98&usage_type=default&display_rank=2.Google Scholar
Neschis, DG, Golden, MA. Clinical features and diagnosis of lower extremity peripheral artery disease. UpToDate. May 2020. www.uptodate.com/contents/clinical-features-and-diagnosis-of-lower-extremity-peripheral-artery-disease?source=search_result&search=Clinical+features+and+diagnosis+of+lower+extremity+peripheral&selectedTitle=1%7E150.Google Scholar
Crawford, F, Hollis, S. Topical treatments for fungal infections of the skin and nails of the foot. Cochrane Database Syst Rev. 2007; 3:CD001434.Google Scholar
Baran, R. The nail in the elderly. Clin in Derm. 2011; 29:54–60.Google Scholar
Welsh, O, Ver-Cabrera, L, et al. Onychomycosis. Clin in Derm. 2010; 28:151–159.CrossRefGoogle ScholarPubMed
Ferreira, E, Portella, MR, Doring, M. Changes to the feet of institutionalized elderly persons. Rev bras geriatr gerontol, Rio de Janeiro. 2018; 21(3):352–359.Google Scholar
Allevato, MAJ. Diseases mimicking onychomycosis. Clin in Derm. 2010; 28:164–177.Google Scholar
Ward, K, Kosinski, MA, et al. Podiatry. In: Fillit, H, Rockwood, K, eds. Brocklehurt’s Textbook of Geriatric Medicine and Gerontology. 7th edition. Philadelphia, PA: Saunders, an imprint of Elsevier, 2010.Google Scholar
Dufour, AB, Casey, VA, et al. Characteristics associated with hallux valgus in a population-based study of older adults: The Framingham foot study. Arthr Care & Research. 2014; 66(12):1880–1886.CrossRefGoogle Scholar
Wulker, N, Mittag, F. The treatment of hallux valgus. Dtsch Arztebl Int. 2012; 109(49):857–868.Google ScholarPubMed
Healy, A, Farmer, S, Pandyan, A, Chockalingam, N. A systematic review of randomized controlled trials assessing effectiveness of prosthetic and orthotic interventions. PLoS ONE. 2018; 13(3):e0192094.Google Scholar
Barg, A, Harmer, J, Presson, AP, Zhang, C, Lackey, M, Saltzman, CL. Unfavorable outcomes following surgical treatment of hallux valgus deformity: A systematic literature review. J Bone Joint Surg Am. 2018; 100:1563–1573.Google Scholar
Torkki, M, Malmivaara, A, Seitsale, S, Hoikka, V, Laippala, P, Paavolainen, P. Hallux valgus: Immediate operation versus 1 year of waiting with or without orthoses: a randomized controlled trial of 209 patients. Acta Orthop Scand. 2003; 74(2):209–215.Google Scholar
Menz, HB. Disorders of the toes. In: Foot Problems in Older People: Assessment and Management. Edinburgh: Churchill Livingstone/Elsevier, 2008.Google Scholar
Thomas, JL, Blitch, EL, et al. Diagnosis and treatment of forefoot disorders. Section 1: Digital deformities. Journal of Foot and Ankle Surgery. 2009; 48:230–272.Google Scholar
American Health Network, Indiana: American Health Network-Central Services Organization, 2014. www.ahni.com/Specialties/Foot+and+Ankle/Articles/Common+Disorders/Sesamoiditis.html.Google Scholar
Adams, II WR. Morton’s neuroma. Clin Podiatr Med Surg. 2010; 27:535–545.Google Scholar
Jain, S, Mannan, K. The diagnosis and management of Morton’s neuroma: A literature review. Foot Ankle Spec. 2013; 6:307–317.Google Scholar
Caselli, MA, George, DH. Foot deformities: Biomechanical and pathomechanical changes associated with aging, part I. Clin Podiatr Med Surg. 2003; 20:487–509.Google Scholar
Katchis, SD. Posterior tibial tendon dysfunction. In: Ranawat, CS, Positano, RG, eds. Disorders of the Heel, Rearfoot and Ankle. Philadelphia, PA: Churchill Livingstone, 1999.Google Scholar
Geideman, WM, Johnson, JE. Posterior tibial tendon dysfunction. Orthop Sports Phys Ther. 2000; 30:68–77.Google Scholar
Trojian, T, Tucker, AK. Plantar fasciitis. Amer Fam Physic. 2019; 99(12):744–750.Google Scholar
Healey, K, Chen, K. Plantar fasciitis: Current diagnostic modalities and treatments. Clin Podiatr Med Surg. 2010; 27:369–380.Google Scholar
Barrett, SL. Endoscopic plantar fasciotomy. Clin Podiatr Med Surg. 1994; 11(3):469–481.Google Scholar
Tu, P. Heel pain: Diagnosis and management. Am Fam Physic. 2018; 97(2):86–93.Google Scholar
Lewis, T, Cook, J. Fluoroquinolones and tendinopathy: A guide for athletes and sports clinicians and a systematic review of the literature. J Athl Train. 2014; 49(3):422–427.CrossRefGoogle Scholar
Ahn, JM, El-Khoury, GY. Radiologic evaluation of chronic foot pain. Am Fam Physician. 2007; 76:975–983.Google Scholar
Wallach, DM, Katchis, SD. Tarsal tunnel syndrome. In: Ranawat, CS, Positano, RG, eds. Disorders of the Heel, Rearfoot and Ankle. Philadelphia, PA: Churchill Livingstone, 1999.Google Scholar
Helfand, AE. Assessing and preventing foot problems in older patients who have diabetes mellitus. Clin Podiatr Med Surg. 2003; 20:573–582.Google Scholar
Khanolkar, MP, Bain, SC, Stephens, JW. The diabetic foot. Q J Med. 2008; 101:685–695.Google Scholar
Bakker, K, Apelqvist, J, Lipsky, BA, et al. International Working Group on the diabetic foot. The 2015 IWGDF guidance documents on prevention and management of foot problems in diabetes: Development of an evidence-based global consensus. Diabetes Metab Res Rev. 2016; 32(Suppl. 1):2–6.Google Scholar
Botek, G, Anderson, MS, Taylor, R. Charcot neuroarthropathy: An often overlooked complication of diabetes. Clev Clinic J Med. 2010; 77(9):593–599.Google Scholar
Aslam, F, Michet, C. My treatment approach to gout. Mayo Clin Proc. 2017; 92(8):1234–1247.Google Scholar
Zhu, Y, Pandya, BJ, Choi, HK. Comorbidities of gout and hyperuricemia in the US general population: NHANES 2007–2008. Am J Med. 2012; 125(7):679–687.Google Scholar
Scott, JT. Gout and other crystal arthropathies. In: Evans, J, Williams, T, eds. Oxford Textbook of Geriatric Medicine, 2nd edition. Oxford: Oxford University Press, 2000.Google Scholar
Dieppe, PA. Investigation and management of gout in the young and the elderly. Annals of Rheumatic Diseases. 1991; 50:263–266.Google Scholar
Awale, A, Hagedorn, TJ, Dufour, AB, et al. Foot function, foot pain, and falls in older adults: The Framingham foot study. Gerontology 2017; 63:318–324.Google Scholar
www.cdc.gov/steadi/pdf/STEADI-Algorithm-508.pdf.Google Scholar
Muchna, A, Najafi, A, Wendel, CS, Schwenk, M, Armstrong, DG, Mohler, J. Foot problems in older adults: Associations with incident falls, frailty syndrome, and sensor-derived gait, balance and physical activity measures. J Amer Podiatr Med Assoc. 2018; 108(2):126–139.Google Scholar
Yamashita, K, Anzai, E, Yamashita, T, Ohta, Y, et al. Reduction in fall risk and medical cost with foot care in the elderly. Adv Biomed Eng. 2017; 6:83–87.Google Scholar
Kosinski, M, Ramcharitar, S. In-office management of common geriatric foot problems. Geriatrics. 1994; 49(5):43.Google Scholar
Menant, JC, Steele, JR, Menz, HB, et al. Optimizing footwear for older people at risk of falls. J Rehab Research and Development. 2008; 45:1167–1182.Google Scholar
Jellema, AH, Huysmans, T, Hartholt, K, an der Cammen, TJ. Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear. Maturitas. 2019; 127:64–81.CrossRefGoogle ScholarPubMed
Bryant, JL, Beinlich, NR. Foot care: Focus on the elderly. Orthop Nursing. 1999; 18(6):53–60.Google Scholar
Esquenazi, A, Thompson, E. Management of foot disorders in the elderly. In: Felsenthal, G, Garrison, SJ, Steinberg, FU, eds. Rehabilitation of the Aging and Elderly Patient. Baltimore, MD: Williams & Wilkins, 1994.Google Scholar

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