If you love your granny, buy her some new shoes -- but be sure to do your shopping at Foot Locker, not on Fifth Avenue.
A new study shows that falls, one of the leading causes of death among the elderly, could be sharply reduced if people wore sensible shoes. And the best shoes of all are rubber-soled sneakers.
"Sneakers tend to be comfortable shoes, said Thomas Koepsell, a professor of epidemiology at the University of Washington and the lead author. "They make people a little more sure-footed."
The research, published in the Journal of the American Geriatrics Society, found that seniors who wore any type of shoes other than sneakers increased their risk of falling by more than 30 per cent.
The variations in risk based on type of shoe -- loafers, slip-ons, heels, slippers, boots -- were minimal. But the most dangerous option of all proved to be going shoeless.
People who walked barefoot or in stocking feet were 10 times as likely to fall as those who wore sneakers, the researchers found.
According to the U.S. National Center for Injury Prevention and Control, which funded the study, more than one-third of adults age 65 and older suffer serious falls each year.
Most falls occur while people are walking on level surfaces (not on stairs) and are preventable if people make a little effort to eliminate hazards around the home.
The NCIPC recommends removing potential tripping hazards such as throw rugs, unstable furniture and clutter in hallways; using non-slip mats in the bathtub and shower; having grab bars in the tub and beside the toilet; having handrails on both sides of all stairways; and ensuring there is good lighting throughout the home.
Another common source of falls is side effects of medication, so seniors should regularly review their medications -- particularly sleeping pills, tranquillizers and blood-pressure drugs -- with a physician or pharmacist.
The new research was designed to look at another factor: footwear choices.
A total of 1,371 people over the age of 65 living in the Seattle area were monitored for falls over a two-year period. Participants were asked to report each fall and, when they did, they were interviewed about the circumstances and their shoes were examined.
There were 327 falls reported during the study period. One in every four falls resulted in injuries, ranging from cuts and bruises to skull fracture. But researchers acknowledged that many falls, and particularly serious injuries and death, may not have been reported.
Athletic and canvas shoes, commonly known as sneakers, proved to be the safest.
Dr. Koepsell said the low heel, strong-grip bottom and the firm support offered by sneakers make them the best choice.
Falls, which most often lead to hip and skull fractures, are one of the leading causes of death, hospital admission and nursing home admission. Hip fractures, for example, are remarkably devastating: One in five seniors who breaks a hip dies within a year.
In Canada alone, more than 5,000 seniors die of falls annually.
The World Health Organization has warned of an impending epidemic of hip fractures due to the aging population. The international agency predicted that the number of hip fractures will triple by the year 2050, to 6.3 million annually, up from 1.7 million. Today, most of those injured live in the developed world but in 50 years, more than 75 per cent will live in developing countries, according to WHO.
Most who suffer broken hips are postmenopausal women suffering from osteoporosis, a condition that is largely preventable. Women live about one-third of their lives after menopause.
Many geriatric experts believe fall prevention should be the No. 1 public-health priority among seniors, particularly women, because falls have such a detrimental effect on quality of life.
André Picard