Incorporating foot assessment in the comprehensive geriatric assessment.

Area of Science:

• Geriatric Medicine
• Podiatry
• Public Health

Background:

• Foot problems are prevalent in older adults, impacting function, fall risk, and quality of life.
• Comprehensive Geriatric Assessment (CGA) is standard care but often excludes podiatry for hospitalized elderly patients.

Purpose of the Study:

• To assess the prevalence of foot disease, risk factors, and footwear issues in hospitalized older adults.
• To evaluate inter-rater reliability of foot assessments and current podiatry input.
• To explore associations between patient characteristics and foot disease risks.

Main Methods:

• A prospective, observational cohort study involving older adults on geriatric rehabilitation wards.
• Foot assessments were conducted using the Queensland Foot Disease Form (QFDF) alongside routine CGA.

Main Results:

• 12% of patients had foot disease, and 25% were at high risk; common risk factors included peripheral arterial disease (17%), neuropathy (19%), and foot deformity (22%).
• 85% wore inappropriate footwear. Podiatry services were accessed by only 15% of patients, primarily those with existing foot disease.
• Patients with foot disease or at-risk feet had significantly longer hospital stays and higher malnutrition screening scores.

Conclusions:

• Foot disease, risk factors, and inappropriate footwear are common in hospitalized older adults.
• Current podiatry intervention is limited, often only to those with diagnosed foot disease.
• Routine podiatry assessment should be integrated into multidisciplinary CGA teams, with screening for arterial disease and malnutrition to identify at-risk individuals.