Affects of Aging on the Feet
Yes, even as we age, we need to protect our feet and ankles!
As part of aging, we gradually have an increased risk of developing foot problems. Our circulation, nerve conduction, muscle strength, flexibility and proprioception (balance), can all be affected individually or collectively as part of normal and abnormal aging.
Problem: Dry Skin
As the skin ages, it can become dryer and therefore have a higher risk of developing fissures (deep cracks in the skin) which may become very painful, and even infected.
The skin around your foot and ankle must be kept appropriately moisturized with a “foot moisturizer”, versus just using a standard body or hand lotion. Foot moisturizers contain ingredients designed specifically for the thicker skin on the soles of our feet. It is also important to remember to not apply moisturizers between the toes, where absorption may be diminished. Poor absorption between the toes could progress to further cracking in the web spaces and fungal infections.
Problem: Wearing down of foot padding
The fat padding on the soles of the feet may also wear down over time. This can lead to chronic pain, development of calluses and even wounds or ulcers.
Preventing these problems, can be improved with using the proper foot gear, cushioned socks and cushioned insoles.
Problem: Blood vessels thicken and stiffen
Aging can affect the circulatory system of the lower extremity in many ways. The blood vessels thicken and become stiffer. This leads to slower exchange of appropriate nutrients and stagnation of waste products. As we grow older, our bodies accumulate more fat as muscle tone diminishes and overall we have less total body water. This can lead to anemia and reduced healing time when injuries occur in our feet. Most of the overall number of white blood cells stay the same as we age. However, certain white blood cells important in fighting infection, (neutrophils) decrease, and thus we have a reduced ability to fight off infection. Collectively, these factors can be associated with an increase in the risk of blood clots, (deep vein thrombosis, DVT), peripheral vascular disease, (often presenting as intermittent pain in the legs when walking), varicosities (superficial prominent veins).
Having a detailed medical examination with your Podiatrist will help you lower the risks of developing these chronic problems.
Problem: Changes to our nervous system
The process of aging causes our nervous system to undergo unique changes. The brain and spinal cord lose nerve cells and weight (atrophy). Nerve cells may begin to pass messages more slowly than in the past, (poor conduction). Gradual deterioration of your peripheral nervous system which may be seen in diabetes, vascular problems, or other primary neurological disorders can all affect your peripheral sensations in your feet, and in certain instances, can result in diminished appropriate reflex responses. Neuropathy (disease or dysfunction of one or more peripheral nerves, typically causing numbness or weakness) can cause people with diabetes to lose the ability to perspire. Neuropathy may affect people with diabetes as well as other diseases. Diabetics can benefit from a thorough evaluation by a podiatrist to determine the exact cause and appropriate treatment before neuropathy worsens.
Evaluation of the nervous system by a podiatrist for the lower extremity is very helpful. From here further testing can be done to determine the “cause” for the nerve problems. Accordingly the treatment plan can be determined to address the specific cause and symptoms.
Problem: Gait and balance deterioration
In a 2006 study published in The Journal of American Geriatric Society, gait (ability to walk appropriately), disorders were detected in approximately 25% of persons age 70-74 and nearly 60% of those 80-84 years old. The most common causes of gait and balance disorders include arthritis and orthostatic hypotension. However, multiple studies have also found that gait and balance disorders are multifactorial in 75% of older patients. Problems related to psychiatric issues, cardiovascular disease, infectious and metabolic disease, recent hospitalization, medication use, among others can all adversely affect a patient’s gait.
Evaluation of gait and balance is an essential step in identifying persons at an increased risk of falling and preventing fractures. A team medical approach with your primary care physician and Podiatrist can help prevent problems that may occur with poor gait. Your Podiatrist can provide the most appropriate assisted device that can help older patients prevent falls. Preventing falls and the complications related to them, help diminish the overall morbidity that can develop in our elderly patient population.
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