Every year in the United Kingdom, one in three people over 65 will fall. This rises to almost half with people aged 80 and above. Falls are the single, biggest reason for admission to the hospital and presentations to the emergency department in people aged 65 years and over. Falls account for over four million days spent in the hospital a year in England alone.
Ninety-five percent of hip fractures occur as a result of a fall, and they can also result in impaired mobility, disability, fear of falling and reduced quality of life. In a research study by Irwanto et al. (December 2014), a fall is the cause of most fractures in older people.
In the United States, falls are the leading cause of fatal and non-fatal injuries among older people. In 2010, 2.3 million fall injuries sent older persons to the emergency room where 662,000 of them were admitted to hospital, and falls cost $30 billion in direct medical costs.
A fall can have a huge impact on the life of the older person. It destroys their confidence, increases isolation and reduces independence, and often they can no longer live alone.
Reducing your personal risk factors
Our bodies continue to change throughout our lives as part of normal aging. Some of these changes can increase the risk of falling. These include poorer eyesight, can't see quite as clearly, can't judge distances and depth, or can't cope with sudden changes in light or glare; weaker muscles and stiffer joints which makes balance worse and changes the way you walk (gait) and move around; neuropathy or less feeling in the feet and legs, increased likelihood of pain -- numbness, tingling and burning in the feet and even changes to the shape and flexibility of the feet; slower reaction times and more difficulty concentrating or paying attention.
Footwear is one of a number of risk factors in the prevalence of falls. Some shoes or slippers can make you more likely to slip, trip or stumble.
Other conditions, such as diabetes, Alzheimer's disease, dementia or gait disorders such as Parkinson's disease can all increase the risk of falling. Make sure your medical conditions are under control to prevent falls.
Factors that can contribute toward falls
Foot conditions such as bunions, claw toes, ingrown toenails or very long nails and general foot pain can all cause problems with gait and balance. Older people should be advised to check their feet regularly and speak to their podiatrist if they have any reduction in foot sensation or develop foot pain.
Following a simple foot care routine can help reduce the risk of falls by preventing some of the conditions that cause pain and problems -- such as washing and drying feet daily to prevent infection, applying moisturizer to keep skin healthy, cutting toenails regularly and regular podiatry care for the management of foot problems.
Exercise also plays a vital role in preventing falls. Research has shown that a program of strength and balance can be very effective in reducing the risk. Older people are encouraged to do regular exercise to improve toe and ankle strength as this can help to improve balance.
Shoe types that increase the risk of falls
Some footwear can increase the risk of slips, trips and falls by making people more prone to poor balance and bad gait, or by making it difficult to judge surface friction and distance from the floor. Examples of unsuitable footwear for the elderly include loose, worn or backless slippers which are one of the most common causes of older people falling; slip-on shoes such as sling backs or flip-flops can slip and trip you up; shoes with slippery or worn soles can cause you to slip, especially in wet weather; shoes with a heel higher than one inch, or with a narrow heel, can make your foot unstable and can cause you to twist your ankle.
Preventing falls
There are some simple things people can do to help themselves stay steady on their feet and prevent falls.
Preventing falls among older Americans is a top health priority, and improved balance can help reduce the risk of a fall. Proper footwear can help improve balance, especially in older people who may be struggling with mobility and balance issues.
A study published in the British Medical Journal found that a multi-faceted foot care program could reduce the number of falls by 36 percent. It stated that foot and ankle exercises, foot orthoses and wearing appropriate footwear are all key to preventing falls.
The best shoes to prevent falls
Wearing well-fitting shoes can improve walking and gait, and prevent falls. Safe shoes have a high back or collar to support the ankle, a hard, slip-resistant sole, and a heel height lower than one inch.
A house shoe that can offer the comfort of a slipper, but the stable support of a shoe, can be worn in the house rather than walking barefoot, or in socks or tights because they are slippery and can lead to falls. A strong Velcro fastener or leases on the front of the shoes to ensure they won't slip off; a wide opening to make it easier to get your foot in and out of the slipper/shoes with restricted mobility.
Shoe shopping tips
o Have both feet professionally measured every time you shoe shop. Natural aging and health changes can cause the size of your feet to change.
o Shoe shop in the afternoon, as your feet tend to swell throughout the day.
o Bring the type of socks you plan to wear with the shoes, and walk around the store in the shoes before you purchase them.
o If you don't feel comfortable or steady in the store, don't purchase the shoes. Shoes should feel comfortable and supportive right away; if they don't, breaking them in won't improve things.
o If you have specific health challenges or foot issues, talk to the podiatrist about the best footwear for your needs.
o If your podiatrist has prescribed orthotics (biomechanical inserts that go into your shoes) take them with you when you shoe shop and try them out in the shoes you're considering.
o Quality shoes can be an investment, so purchase the best quality shoes you can afford.
If you or a parent of loved one has fallen more than once in the past six months, you or they are more likely to fall again, if no action is taken to prevent it. It is important to talk to your doctor about your risk of falls. Falls are serious, and can be a sign of a new or worsening medical problem, muscle weakness, balance problems, medication side effects or a combination of these and other problems. Wearing proper footwear is an easy way to help improve balance and prevent falls in older people who may be struggling with mobility and balance issues.

o For more information email foothealth242@gmail.com or visit www.apma.org. To see a podiatrist visit Bahamas Foot Centre on Rosetta Street, telephone 325-2996, or Bahamas Surgical Associates Centre, Albury Lane, telephone 394-5820, or Lucayan Medical Centre on East Sunrise Highway, Freeport, Grand Bahama, telephone 373-7400.

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