Despite the clinical impression that foot disorders are a common cause of falls and adverse events in older persons, little population-based data exist to support this view. Foot disorders are often overlooked as significant potential causes of falls and little work has evaluated significant mediators, such as balance or gait in older persons. Both falls and foot disorders represent major public health problems that will only increase in importance as the population ages. We propose to examine the impact of specific foot disorders upon falls, and further to evaluate whether balance or gait affect this relation. We will link a comprehensive assessment of foot disorders to observed falls over a two-year follow-up, as well as to the observed physical performance, balance and gait measures that might modify the relation. Our 3 specific aims of this project will examine the longitudinal relations between 1) foot disorders and falls, 2) foot disorders and falls considering a pathway via poor balance, 3) foot disorders and falls, considering a pathway via impaired gait, and a secondary aim exploring the relation between footwear and falls. ? ? It is significant to examine intervening variables, or mediators, as they may clarify the nature of the relation between foot disorders and falls, and also since they are potential targets for future interventions. No other cohort has linked detailed information on foot disorders in elders to comprehensive longitudinal falls information and no study thus far, has examined the roles of balance, gait, or footwear in an population evaluation of foot disorders and falls. The proposed study will provide essential information on associations of keen interest both to clinical medicine and public health in 'he field of aging. Results will help us to design future interventions, such as foot care, shoes and specific devices to reduce the risk of falls among elderly people. This project will make extensive use of the recruitment resources and data collection from an already funded program project grant (Principal Investigator: L. Lipsitz, Grant # AG04390, 7/01/04 - 06/30/08, """"""""HRCA/Harvard Research Nursing Home""""""""). Based on preliminary data, this study will provide new and significant information about the role of foot disorders upon new falls in elderly men and women over a two-year follow-up. A greater understanding of foot disorders in older individuals may lead to better understanding of the strategies to prevent falls. ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Research Project (R01)
Project #
5R01AG026316-04
Application #
7484081
Study Section
Special Emphasis Panel (ZRG1-HOP-Q (02))
Program Officer
Nayfield, Susan G
Project Start
2005-09-01
Project End
2010-07-31
Budget Start
2008-08-01
Budget End
2009-07-31
Support Year
4
Fiscal Year
2008
Total Cost
$353,424
Indirect Cost
Name
Hebrew Rehabilitation Center for Aged
Department
Type
DUNS #
030832075
City
Boston
State
MA
Country
United States
Zip Code
02131
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Li, Wenjun; Procter-Gray, Elizabeth; Lipsitz, Lewis A et al. (2014) Utilitarian walking, neighborhood environment, and risk of outdoor falls among older adults. Am J Public Health 104:e30-7
Duckham, Rachel L; Procter-Gray, Elizabeth; Hannan, Marian T et al. (2013) Sex differences in circumstances and consequences of outdoor and indoor falls in older adults in the MOBILIZE Boston cohort study. BMC Geriatr 13:133
Nguyen, Uyen-Sa D T; Dufour, Alyssa B; Positano, Rock G et al. (2013) The occurrence of ipsilateral or contralateral foot disorders and hand dominance: the Framingham foot study. J Am Podiatr Med Assoc 103:16-23
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Kelsey, Jennifer L; Procter-Gray, Elizabeth; Hannan, Marian T et al. (2012) Heterogeneity of falls among older adults: implications for public health prevention. Am J Public Health 102:2149-56
Kelsey, Jennifer L; Procter-Gray, Elizabeth; Berry, Sarah D et al. (2012) Reevaluating the implications of recurrent falls in older adults: location changes the inference. J Am Geriatr Soc 60:517-24
Riskowski, Jody L; Hagedorn, Thomas J; Hannan, Marian T (2011) Measures of foot function, foot health, and foot pain: American Academy of Orthopedic Surgeons Lower Limb Outcomes Assessment: Foot and Ankle Module (AAOS-FAM), Bristol Foot Score (BFS), Revised Foot Function Index (FFI-R), Foot Health Status Questionnair Arthritis Care Res (Hoboken) 63 Suppl 11:S229-39
Riskowski, Jody; Dufour, Alyssa B; Hannan, Marian T (2011) Arthritis, foot pain and shoe wear: current musculoskeletal research on feet. Curr Opin Rheumatol 23:148-55

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