Background/Purpose:   Foot symptoms (symptoms=pain, aching, and stiffness) are common in older adults and are associated with poorer physical function, but their contribution to risk of falling is understudied.  The purpose of this cross-sectional study was to examine whether presence and severity of foot symptoms were associated with falls in a community-based cohort of African American and Caucasian men and women 50+ years old.

Methods:   Of 1,690 Johnston County Osteoarthritis Project participants who completed questionnaires about falls from 2006-2010, complete data on foot symptoms, history of falls, and participant characteristics were available for 1,406 participants (mean age 68 ± 9 years, mean body mass index [BMI] 32 ± 7 kg/m², 66% women, 30% African American, 22.4% with <12 years of school).  Falls (yes/no) were queried as: “In the last 12 months, have you had any falls of any type?”  If they responded “yes”, they reported the number of falls.  Presence of foot symptoms (yes/no) was defined based on the question: “On most days, do you have pain, aching or stiffness in your left/right foot?”  Foot symptom severity was recorded as none (referent), mild, moderate, or severe.  Logistic regression models were used to estimate the association between foot symptoms and falls (defined two ways as ≥1 fall and ≥2 falls), adjusting for history of falls, age, BMI, gender, race, education (12+ years vs. <12 years) and other lower body symptoms at the low back, hip, or knee.  Statistical interaction between foot symptoms and each covariate was examined, with a p-value of <0.10 for interaction considered statistically significant.

Results:   Foot symptoms were reported by 341 (24.3%) participants, and symptoms were severe for 4.3% of participants, moderate for 10.7%, and mild for 9.3%.  In the past 12 months, 26.9% of participants reported 1 or more falls and 10.5% reported 2 or more falls.  22.2% participants had a history of falls, and 60.1% had other lower body symptoms.  Foot symptoms were associated with falls during the past 12 months (Table).  Compared to those without foot symptoms, those with foot symptoms had 60% higher odds of sustaining at least one fall and 90% higher odds of sustaining at least 2 falls.  The odds of falling increased with greater foot symptom severity (Table).  There were no interactions between foot symptoms and any of the covariates.

Conclusion:   Foot symptoms were significantly associated with falls during the past 12 months, with odds increasing with greater severity of foot symptoms.  Surprisingly, there were no interactions, especially by race or BMI.  Fall prevention measures may target foot interventions specifically to reduce foot symptoms or to slow progression of symptom severity to prevent future falls.