1184 - Population-Based Study of Foot Disorders in Men and Women from the Framingham Study

Marian T. Hannan1, Christine E. McLennan1, M. C. Rivinus1, H. J. Hillstrom2, J. Kaplan1, M. Lu1, K. E. Broe1, D. P. Kiel1. 1Hebrew SeniorLife, Boston, MA; 2Hospital for Special Surgery, New York, NY
Presentation Number: 1184

Foot problems are thought to be common yet clinicians often overlook their importance. Further, it is not clear what foot disorders may regularly occur in older persons. As little population-based information exists in adults, the purpose of our study was to describe the prevalence of foot disorders in a population-based epidemiologic study of men and women. We used a validated foot exam with specific criteria to assess 25 foot disorders (eg, hallux valgus, structural foot deformities, edema, plantar fasciitis, pes planus) and foot symptoms. One trained examiner (MCR) did all foot exams. Prevalence was examined in age groups: 44-54, 55-64, 65-74 and 75-100 yrs and for men and women separately.
The study sample was a cross-sectional cohort of 2231 adults from the population-based Framingham Study who were ambulatory and cognitively intact. Mean age was 66y (range 39-99y), 57% were female, and mean weight was 173 lbs (79-376). The most prevalent foot disorders were hallux valgus (39%), pes planus (31%), hammer toes (24%), corns (19%), fat atrophy (ball of foot 29%, heel pad 21%), ankle edema (10%), overlapping toes (11%) and Morton’s neuroma (10%). Others occurred in <10%: Tailor’s bunion (4%), plantar fasciitis (6%), hallux ridigus (6%) and claw toes (2%).
Similar prevalence by sex was seen for overlapping toes, plantar fasciitis, Morton’s neuroma, Tailor’s bunion and claw toes. Women had double the prevalence compared to men for corns, fat pad atrophy and ankle edema (prevalence in women ranged from 1.5 to 2 times greater than that in men). Foot pain on most days was reported by 28% (32% women, 21% men), and 43% reported that shoes caused their foot pain (52% women, 29% men). Across locations of foot pain (toes, ball of foot, forefoot, heel, arch and hindfoot), women had about double the prevalence rates seen in men at most sites ( prevalence range for women was 6%-20%; for men, 3%-11%).
Prevalence of most foot disorders increased with age group (eg, H. valgus, prevalence across age groups: 21%, 32%, 30% and 51%) except plantar fasciitis which was most common in those aged 44-54 (9%, 5%, 2% and 1% across age groups). Prevalence of foot pain was highest for those in the 75-100y group.
This study provides population-based data on the prevalence of foot disorders in adults, showing that structural problems and foot pain are common, especially in women. Foot disorders increase with age (except plantar fasciitis). A greater understanding of foot disorders and pain may lead to better public health interventions in the community and is essential to allow better prevention of foot problems in the community. NIAMS R01

 M.T. Hannan, None; C.E. McLennan , None; M.C. Rivinus , None; H.J. Hillstrom, None; J. Kaplan, None; M. Lu, None; K.E. Broe, None; D.P. Kiel, None.