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    NOVEMBER 18, 2004
 
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Aged feet find relief at Podiatric Clinic


Photo by Jeanne Martino
James B. McGuire, director of the Leonard S. Abrams Center for Advanced Wound Healing and chairman of the department of medicine, consults with patient Walter Johnson in the Foot and Ankle Institute at the School of Podiatric Medicine.

November is American Diabetes Month, and podiatric medical professors and students at the School of Podiatric Medicine are urging diabetic patients over the age of 65 to pay special attention to their feet.

In the coming decade, podiatrists will increasingly encounter aging patients as the United States’ population grows older. Every seven seconds, another baby boomer turns 50, according to the Alliance for Aging Research. In 2011, this group will begin to turn 65, and by 2030, approximately one in five people will be age 65 or older, according to the American Geriatrics Society.

The life expectancy of this large population of Americans is also continuing to grow. The Centers for Disease Control and Prevention report that the average life expectancy in 1900 was 47 years, while today’s life expectancy is more than 77 years. Along with an increased life expectancy, these individuals have better health and are more active then any generation before.

“As you age, so do your feet,” said James B. McGuire, director of the Leonard S. Abrams Center for Advanced Wound Healing and chairman of the department of medicine at the School of Podiatric Medicine. “Your feet have walked you through 115,000 miles and borne several million tons of weight up to this point in your life; this could mean the possibility of any number of foot problems.”

Many older patients also develop diabetes, which presents an additional challenge for podiatrists. Because diabetics often experience a loss of sensation related to elevated blood sugar, it is hard for them to feel the pain associated with a wound or injury. Diabetic patients must be extremely vigilant with any break in the skin because infection and inflammation can develop and cause significant damage to the foot.

“Diabetic infections often become serious in a 24-hour period,” said McGuire, who urges diabetics to contact a local podiatrist at the first sign of a skin break. “By the time [most aging diabetics] think the problem is serious enough to see their podiatric physician, they already have a deep ulcer and their foot is at risk for severe infection or even amputation.”

But diabetes is not the only serious foot and lower extremity issue faced by older Americans.
“Profound loss of flexibility and muscle strength, as well as degenerative joint changes, are common in the aging individual,” said Kendrick A. Whitney, assistant professor in the department of podiatric orthopedics at the School of Podiatric Medicine. “In addition to bone loss leading to osteoporosis, skeletal mass decreases by 6 percent per decade after age 30.”

Whitney warns that congenital or acquired foot deformities such as pronation, high arches and club foot may further compound these problems by accelerating the wear and tear on the joints, muscles and ligaments. These and other physiological changes, such as the loss of fatty tissue on the bottom of the feet and a loss of balance sensation, are just the beginning of problems that can plague the aging human foot.

Another type of foot problem common in those 55 and older is arthritis. There are two basic types of arthritis: osteoarthritis, which is often caused by trauma or a history of joint infection, and rheumatoid arthritis, where the immune system attacks the body’s own tissue. Each of the foot’s 33 joints is susceptible to the tenderness, pain, swelling and limited motion associated with arthritis.

McGuire recommends that patients with arthritis see their local podiatrist, who can identify deformities before a debilitating arthritic condition develops and can also prescribe medication, therapies and special footwear to correct or treat the problems associated with this ailment. In many cases, early detection is the key to preventing further complications that can lead to long-term problems.

McGuire and Whitney also suggest that everyone — old, young, sick and well — inspect their feet daily for blisters, swelling, cuts, itching, redness, cracks or skin color changes. They also suggest rotating shoes daily and using an antiperspirant on the feet to control excessive sweating.

McGuire and Whitney both find proper shoe fit to be the best defense against foot problems. They suggest that individuals wear shoes that resemble the shape of their feet and choose the correct shoe for each activity. Also, shopping for shoes in the late afternoon will make for a better shoe fit by accounting for foot swell.

- By Tory Harris


 

 


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