Title: Geriatric Podiatric Assessment Tool Presented at Annual Meeting

Author:

Section/SPIG: Podiatric Health

Issue Date:

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Patients with cognitive decline may neglect developing or existing foot disorders. Such patients may be unaware of or unable to comprehend a problem. During the recent APHA Annual Meeting in Washington, D.C., Arthur E. Helfand, DPM, Temple University, School of Podiatric Medicine and School of Medicine in Narberth, Penn., outlined body system and quality of life changes associated with high risk foot problems in this patient population. In conjunction with the Pennsylvania Department of Health, Helfand has developed a podiatric assessment protocol for geriatric patients, which is included in the May/June 2004 issue of the Journal of the American Podiatric Medical Association, (Vol. 94, No. 3, pages 293-304). Among 1,000 patients 65 years and older evaluated at the Podogeriatric Assessment Center at Temple University, the protocol identified nearly 75 percent with foot pain, about 94 percent with onychodystrophy, more than 64 percent with one or more foot deformities, and 64 percent with sensory loss. These problems occurred despite more than 97 percent of the patients using satisfactory hygiene practices and nearly 64 percent wearing satisfactory footwear.


Systemic/Life changes contributing to high risk foot problems include:

chronic constipation and incontinence;

weakened muscle and bone structure;

impaired cardiovascular function;

diabetes mellitus;

peripheral artery disease;

reduced interest or participation in social activities;

loss of mobility;

a reduction in independent activities of daily living;

sleep problems;

Agitation, compulsive activities;

increased foot perspiration;

neurotic excoriation;

self mutilation; and

untreated hyperkeratosis, onychauxis, onychomycosis, ulcers, tinea pedis, xerosis, and abrasions and lacerations.