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From Disability and Rehabilitation:

Foot and leg problems are important determinants of functional status in community dwelling older people

Elizabeth LM Barr, Colette Browning, Stephen R Lord, Hylton B Menz, Hal Kendig

Purpose. To determine whether foot and leg problems are independently associated with functional status in a community sample of older people after adjusting for the influence of socio-demographic, physical and medical factors.

Method. Data were analysed from the Health Status of Older People project, a population-based study involving a random sample of 1000 community-dwelling people aged 65–94 years (533 females, 467 males, mean age 73.4 years±5.87). A structured interview and brief physical examination were used to investigate the associations between self-reported foot and leg problems and functional status. Functional status was assessed using: (i) timed ‘Up & Go’ test, (ii) self-reported difficulty climbing stairs, (iii) self-reported difficulty walking one kilometer, (iv) self-reported difficulty performing instrumental activities of daily living (IADLs), and (v) self-reported history of one or more falls in the previous 12 months. These associations were then explored after adjusting for socio-demographic, physical and medical factors.

Results. Thirty-six percent of the sample reported having foot or leg problems. Univariate analyses revealed that people with foot and leg problems were significantly more likely to exhibit poorer functional status in all parameters measured. After adjusting for socio-demographic, physical and medical factors, foot and leg problems remained significantly associated with impaired timed ‘Up & Go’ performance (OR=2.15, 95%CI 1.55–2.97), difficulty climbing stairs (OR=3.33, 95%CI 1.98–5.61), difficulty walking one kilometer (OR=3.13, 95%CI 2.09–4.69), and history of falling (OR=1.73, 95%CI 1.26–2.37).

Conclusions. Foot and leg problems are reported by one in three community-dwelling people aged 65 years and older. Independent of the influence of age, gender, common medical conditions and other socio-demographic factors, foot and leg problems have a significant impact on the ability to perform functional tasks integral to independent living.

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Regards,

Hylton

I see people who are older a lot. One thing I notice is calf atrophy in older patients.Have any studies been done to that extent?

John,

There's a wealth of literature pertaining to age-related loss of muscle strength (for a recent review, see Doherty TJ. Ageing and sarcopenia. Journal of Applied Physiology 2003; 95:1717-1727). Lower limb muscles generally exhibit age-related declines in strength both earlier and to a greater extent than upper limb muscles, and this loss has a greater impact of mobility.

Simple measurements of calf circumference using a tape measure are a good indicator of strength-related disability, but only provide a very crude measure of actual muscle mass. Ref: Rolland Y, et al. Sarcopenia, calf circumference, and physical function of elderly women: a cross-sectional study. Journal of the American Geriatrics Society 2003;51:1120-4.

Cheers,

Hylton