Understanding the link between foot health complications and falls risk is important in reducing injury risk and supporting healthy ageing in older adults living with diabetes.
Foot health and diabetes
Foot health plays a key role in falls prevention, particularly among older adults living with diabetes. Diabetes can lead to peripheral neuropathy, poor circulation, and foot deformities, all of which increase the risk of falls due to pain, reduced sensation, and balance issues. For example, a loss of sensation in the feet can make it difficult for older adults to identify injuries such as cuts, ulcers or blisters, leading to delayed wound care and increasing the risk of injury. Regular foot checks should be part of diabetes management, looking for signs of swelling, numbness, pressure areas, deformities, and footwear-related damage.
Older adults who have diabetes are twice as likely to have a fall that results in an injury.
Proprioception and falls
Proprioception is the body’s ability to sense its position, movement, and balance. Having good proprioception helps us walk confidently, avoid obstacles, and adapt to uneven surfaces. Diabetes, particularly when complicated by peripheral neuropathy, impairs proprioception by damaging the sensory nerves in the feet. This leads to reduced awareness of foot position and pressure, resulting in unsteady gait, poor posture, and a higher likelihood of tripping or losing balance. Older adults with reduced proprioception may not feel the ground beneath them clearly or detect changes in surface texture, making them vulnerable to environmental hazards and the risk of falls.
Incorporating balance and strength training, alongside education on foot care and safe footwear, can help improve proprioception and reduce falls risk in older adults with diabetes.
Factors when assessing falls risk
There are three key factors to consider concerning feet and footwear when assessing an older adult’s falls risk:
- Footwear: Are the older adult’s shoes safe, and do they fit well?
- Foot conditions: Does the older adult have foot pain or any other foot issues?
- Referral: Do you need to refer the older adult to a podiatrist who may be able to assess these problems further and make recommendations for footwear?
Working together to prevent falls
Health professionals play a key role in identifying and addressing foot-related issues early. A referral to a podiatrist is essential for routine monitoring, orthotic advice, and early intervention. Allied health professionals and people working with older adults in the community can reinforce the importance of daily foot care, footwear assessments, and strength and balance exercises to reduce falls.
For more information about the link between diabetes and foot health, please refer to Diabetes WA.