Do Outpatient Podiatry Evaluations Reduce the Risk of Falls in Elderly Patients With Diabetes Mellitus?

Abstract

Background: Elderly patients with diabetes mellitus (DM) are faced with potential changes in their lower extremities, such as peripheral neuropathy and peripheral arterial disease, making them vulnerable to falls. We hypothesized that evaluations by podiatrists would lower the events of falls.

Methods: A retrospective chart review of a cohort of patients with DM, 65 years or older, was performed, who visited our primary care office between January 1, 2019 and June 30, 2019. Patients were divided into those who had podiatrist evaluations (PODEVAL), and those who did not (no PODEVAL). Events of falls and comorbid medical conditions were compared between the two groups. We also compared the associations of risk factors between the patients who had falls and those who did not.

Results: Among 197 patients (PODEVAL = 92; no PODEVAL = 105), the mean ages of the two groups were comparable (76.9 years for PODEVAL, 75.5 years for no PODEVAL; P = 0.151). There was no significant difference in the events of falls in a 6-month follow-up period between PODEVAL and no PODEVAL groups (35.9% vs. 32.4%; P = 0.606). We found significantly higher frequencies of association of several disorders of the lower extremities in PODEVAL group compared to no PODEVAL group, such as bunions and calluses (48.9% vs. 27.6%; P = 0.002), peripheral arterial disease (50.0% vs. 26.7%; P < 0.001), and peripheral neuropathy (75.0% vs. 47.6%; P < 0.001). Patients with falls had higher frequencies of associations of some comorbidities compared to the patients without reported falls, such as coronary artery disease, peripheral arterial disease, dementia, congestive heart failure, carotid stenosis, and syncope.

Conclusions: Among elderly patients with DM, there is no significant difference in the events of falls between the groups of patients who had podiatrist evaluations and who did not.

J Clin Med Res. 2021;13(12):521-529
doi: https://doi.org/10.14740/jocmr4638