For Older People, Shoes Goeth Before a Fall

(March '98) - Shoes may seem something of a pedestrian subject but the shoes that older people choose are being accused of increasing their risk of falls and injuries.

What's new, you ask? They shouldn't be wearing high heels at their age anyway. No wonder the elderly are always falling down!

Older people should show a little sense and wear sturdy shoes, you say. Old-fashioned Oxfords, loafers, or athletic shoes. They're safer, aren't they? Well, the answer seems to be "No!"

A new study has shown just the opposite. Fully two-thirds of older people who fall are wearing those old-fashioned Oxfords, loafers, or athletic shoes. The study by Dr. Carol Frey, director of the Foot and Ankle Center at Orthopedic Hospital in Los Angeles, was presented recently at a meeting of the American Academy of Orthopedic Surgeons.

Dr. Frey studied 185 men and women over 55 who had fallen and injured themselves during a one-year period. Among those 65 and older, shoes were frequently at fault for the falls that resulted in the injuries. Avoiding a fall may be as simple as changing your shoes.

Dr, Frey's study is the subject of an article by the health writer Jane E. Brody entitled "When the elderly fall, shoes may be at fault" published in The New York Times (Feb. 24).

Athletic shoes are the new wave (or swoosh) in footwear for all ages, including what the French call "le troisieme âge" (the third age). Specifically, how did sneakers fare in Dr. Frey's study? Not too well. Sixty percent of those wearing sneakers when they fell said they fell because their shoes "caught or dragged" on the floor and 40 percent said their athletic shoes were "too slippery." What shoes should older people wear? The recommendations for older people from Dr. Frey and other experts, according to Jane Brody, are as follows (taking the negatives first):

  • Never wear shoes with slippery soles.
  • Never wear shoes with worn soles.
  • Never wear shoes with smooth leather soles.
  • Never wear shoes with smooth plastic soles.
  • Never wear athletic shoes with synthetic soles. (They can be very slippery).
  • Never wear ill-fitting shoes.
  • Never wear loose slippers. (Slippers are easy to put on, but make sure they fit).
  • Beware of shoes with big rubber nubbins on the sole. (They can catch on carpets, especially when worn by people who barely pick up their feet when they walk).
  • Beware of the rubber tips on the toes of running shoes. (They, too, can catch on carpets).
What shoes do experts recommend for older people? (For the sake of safety, senior citizens should not go have to go shoeless!) The experts' positive recommendations are as follows:
  • Consider walking shoes for all-around shoes.
  • Select shoes that provide good traction.
  • Select shoes that provide support (but not with heavy soles or rubber over the toes).
  • Select shoes without too much cushioning (which can destabilize an older person).
  • Select shoes that tie rather than those that slip on the feet. Laced shoes can be adjusted to accommodate swelling of the feet (and orthotics-supports and braces).
  • "For those who lack dexterity," Jane Brody suggests, " consider replacing cloth laces with elastic ones that hold the shoe firmly on the foot, but stretch enough to allow shoes to be slipped on and off without tying or untying the laces."
  • And we would add, shoes with velcro closures are just as good for older people as they are for young kids. Velcro is easy to close, adjust, and open.
To catch your attention, we started this report with a play- on-words-"Shoes may seem something of a pedestrian subject...."-for which we now abjectly apologize. This is not at all a pedestrian topic.

Falls cause some significant injuries, as we all know. Among them, broken hips.

Fall and break a hip and you have one chance in five of dying within a year That risk is on top of whatever chance you already had of dying that year!

The proverb states that "Pride goeth before a fall." For older people, shoes may goeth before a fall (and the same may be true for everyone). Shoes are a serious subject.


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