IHN Database

Footwear linked to risk of falls

SEATTLE, WASHINGTON. Having a fall is the most common cause of fatal injury among older Americans. Non-fatal falls are also common with about one third of live-at-home, older adults experiencing one each year. Overall health status and physical activity level are not significantly related to risk of falling; however, older adults with low hand grip strength and difficulty in getting up from a bed or chair do have a higher risk. The use of walking aids and gait abnormality also increase the risk of a fall.

Researchers at the University of Seattle now report that footwear type is perhaps the most important factor when it comes to preventing falls. The researchers monitored a group of 1371 adults aged 65 years or older for a 2-year period. During this time 327 falls to the ground occurred that met the criteria of being unintentional, not being associated with a loss of consciousness, and not resulting from being hit or pushed. Most falls occurred in or around the home with about 62% taking place while walking on a level surface, 23% occurring at a change of level such as stairs, steps or a curb, and 13% taking place on a slope. About 50% of the falls occurred between noon and 6 pm. Only 2% of all falls occurred during vigorous physical exercise as compared to 43% while walking outdoors and 31% while walking indoors.

The researchers compared the type of footwear worn by the fall victim at the time of the fall with the type worn by non-falling controls engaged in a similar activity at a similar time. They observed a strong correlation between footwear type and the risk of falling. The safest footwear, by far, would seem to be athletic shoes and canvas shoes (sneakers). Being barefoot or in stocking feet was associated with an 11 times higher risk of falling when compared to wearing athletic shoes. Other shoe styles, such as high heels and shoes without heels, increased falling risk by a factor of 2 or more. The researchers conclude that wearing athletic or canvas shoes may be a useful component in intervention programs designed to prevent falls.
Koepsell, TD, et al. Footwear style and risk of falls in older adults. Journal of the American Geriatrics Society, Vol. 52, September 2004, pp. 1495-1501

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