Aging Feet

Foot Health and Aging

In today's modern world, people are living longer - with older persons accounting for an increasingly significant proportion of our total population. Their numbers will continue to grow in the coming years.

If older people are to live useful, satisfying lives, they must be able to move about. Mobility is a vital ingredient of the independence that is cherished by our aging population, and foot ailments make it difficult or impossible for them to work or to participate in social activities.

Recent studies have shown that impairment of the lower extremities, is a leading cause of activity limitation in older people. Foot problems can also lead to knee, hip, and lower back pain that undermine mobility just as effectively. A quarter of all nursing home patients in the US cannot walk at all and a further 15% can walk only with assistance.

Feet : Mirror of Health

The human foot has been called the mirror of health. The first signs of such systemic conditions as diabetes, arthritis, and circulatory disease are often detected by healthcare professionals in the foot. Among these signs are dry skin, brittle nails, burning and tingling sensations, feelings of cold, numbness, and discoloration. Always seek professional care when these signs appear.

What occurs when skin ages?

Aging Process
One or more benign lesions are present on the skin of virtually all individuals older than 65, and the incidence of skin cancer increases dramatically with age. Like all the body's tissues, the skin undergoes many changes in the course of the normal aging process:

• The cells divide more slowly, and the inner layer of skin (the dermis) starts to thin. Fat cells beneath the dermis begin to atrophy (diminish). In addition, the ability of the skin to repair itself diminishes with age, so wounds are slower to heal. The thinning skin becomes vulnerable to injuries and damage.
• The underlying network of elastin and collagen fibers, which provides scaffolding for the surface skin layers, loosens and unravels. Skin then loses its elasticity. When pressed, it no longer springs back to its initial position but instead sags and forms furrows.

The sweat- and oil-secreting glands atrophy, depriving the skin of their protective water-lipid emulsions. The skin's ability to retain moisture then diminishes and it becomes dry and scaly.

With age, numerous changes occur in the feet. Foot disorders often begin early in life and are affected by many factors, such as heredity, gait patterns, level of activity, terrain, and improper foot care.

Shoe styles and fit also affect foot disorders. For example, shoes that are tight or ill-fitting may injure the foot, leg, or hip; may cause falls; or may worsen lesions that are difficult to heal because of peripheral vascular disease or diabetes mellitus. Shoes should provide adequate support and a roomy toe box to compensate for age-related orthopaedic deformities. Feet should be sized and fitted by an experienced fitter each time you new shoes are purchased.

Elderly persons should avoid shoes that are worn or out of shape, offer no support, or have a narrow or pointed toe box. Oxford-type shoes that have shoelaces are recommended; loafers or slip-ons may be constrictive and do not allow compensation for swelling that may occur as the day progresses. Patients who have lost dexterity in their hands and cannot tie shoe laces may benefit from shoes with Velcro closures or shoes with elastic laces, which can remain tied. Shoe horns are available in extended lengths to allow patients to put on their shoes without bending. Shoes can be custom-made and fitted with special inserts made of polyethylene foam to compensate for painful or pre-ulcerous lesions.

Neglect of the feet throughout a person's active years may eventually result in a foot disorder. Symptoms and signs of various systemic disorders (eg. diabetes, heart disease, arthritis, hypertension, peripheral vascular disease) may initially become apparent in the feet. Foot disorders may be particularly problematic for the elderly, who greatly benefit socially and psychologically from being able to remain active. Examination of the feet and treatment of any foot disorders should be part of every preventive healthcare program.

Many elderly patients with corns attempt to provide self care for a variety of reasons. However, elderly patients with limited limb motion, failing eyesight, and unsteady hands may aggravate an apparently minor problem. Also, over-the-counter preparations (eg. salicylic acid), if used without supervision, can damage already sensitised tissue. This problem is especially of concern in patients with diabetes mellitus or peripheral vascular disease.

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