Does the shoe really fit? Characterising ill-fitting footwear among community dwelling older adults: an observational cross-sectional study

Abstract

Background Falls in older people are common and can result in loss of confidence, fear of falling, restriction in activity and loss of independence. Causes of falls are multi-factorial and include extrinsic factors such as unsafe footwear. Inappropriate footwear may increase the risk of falls. There is a paucity of research assessing the footwear characteristics among older people who are at high risk of falls, internationally and in the Irish setting. The aim of this study was to examine the proportion of older adults attending a geriatric day hospital in Ireland who were wearing incorrectly sized shoes. Methods A consecutive sample of 111 older adults aged 60 years and over attending a geriatric day hospital in a large Irish teaching hospital was recruited. Demographic data including age, mobility, medications, use of glasses, social support, footwear worn at home and falls history were recorded. Shoe size and foot length were measured in millimetres using an internal shoe gauge and SATRA shoe size stick, respectively. Subjects’ self-reported shoe size was recorded. Footwear was assessed using the Footwear Assessment Form (FAF). A Timed Up and Go (TUG) score was recorded. Participation was assessed using the Nottingham Extended Activities of Daily Living (NEADL) Scale. Those with shoes fitting on at least one foot were compared to those with ill-fitting footwear on both feet using Chi-square tests, T-tests or Mann–Whitney U tests. Results 72% of participants were wearing footwear that did not fit correctly on both feet according to our definition based on previous literature. Only 6% were wearing footwear that fitted correctly on both feet. 67% wore slippers at home. 90% had shoes with smooth, partly worn or fully worn sole treading. Participant age, TUG score and NEADL score were not associated with ill-fitting footwear. Conclusions Wearing incorrectly fitting shoes and shoes with unsafe features is common among older adults attending geriatric day services. The large number of participants who reported wearing slippers at home is also an important finding. Ill-fitting footwear and slippers are risk factors for falls thus warranting further investigation to help guide future falls prevention services at day hospitals.