INTRODUCTION

Foot problems in the older patient are prevalent and are major factors in podalgia, limitation of mobility, developmental functional disability, impairment, ambulatory dysfunction, gait imbalance, as a causative factor in falls, and increased pain and discomfort. Foot disorders in the older patient are related to the aging process, systemic diseases and/or disorders, focal changes in the foot, and/or complications associated with other medical problems, especially those associated with degenerative joint change and deformity, neurosensory, peripheral arterial, and sensory deficits. Chronic foot conditions limit independence and the quality of life and increase the potential for marked limitation of activity, a fall, hospitalization, and limb loss. The goals of a geriatric foot health program include prevention, detection, assessment, treatment, and management.

ASSESSING AND IDENTIFYING FOOT AND RELATED DISORDERS IN THE OLDER PATIENT

In many instances, because foot, ankle, and related problems are the primary complaint, the patient may seek foot care initially. Preventing complications is essential and a comprehensive approach includes assessment, assessment protocols, risk stratification, practitioner education, patient education, life-long surveillance, appropriate footwear and orthotics as indicated, medical and surgical management of foot conditions, as well as continuing medical and podiatric management.

Comprehensive podogeriatric assessment and risk factor stratification includes identifying those individuals who are most at-risk, and developing proper prevention and management strategies. A comprehensive assessment and risk stratification process was developed for The Pennsylvania Department of Health under contract with the Temple University, School of Podiatric Medicine.