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A Focused Podogeriatric Assessment Study in Ambulatory Care
Arthur E. Helfand
Arthur E. HelfandDepartment of Community Health, Aging and Health Policy, Temple University School of Podiatric Medicine; Department of Medicine, Temple University School of Medicine; and Temple University Institute on Aging, Philadelphia, PA; Temple University Hospital and Temple University Children’s Hospital, Philadelphia, PA; Thomas Jefferson University Hospital, Philadelphia, PA. Mailing address:9 Hansen Ct, Narberth, PA 19072-1712.
This study sought to demonstrate the prevalence of foot conditions in older individuals and their association with chronic risk diseases such as diabetes mellitus, peripheral arterial disease, and arthritis, and to develop care plans to reduce complications from local foot problems and chronic diseases. One thousand individuals older than 65 years who were ambulatory and not institutionalized underwent a standardized and validated podogeriatric examination assessment protocol or index. Overall, 74.6% of all patients had a history of pain, 57.2% were receiving current care for diabetes mellitus, 22.9% indicated current care for peripheral vascular disease, 94.2% had onychodystrophy, 64.2% had one or more foot deformities, 64.0% demonstrated some loss of protective sensation, and 81.7% had one or more symptoms and signs of peripheral arterial insufficiency. These findings demonstrate that foot problems in the older population result from disease, disability, and deformity related to multiple chronic diseases as well as changes associated with repetitive use and trauma. Older people are at a high risk of developing foot-related disease and should receive continuing foot assessment, education, surveillance, and care. (J Am Podiatr Med Assoc 94(3): 293–304, 2004)