Footcare and peripheral arterial disease

Changes in the feet occur with age which can cause pain and other foot pathologies that can lead to falls, foot ulcers and amputation. Some older adults may have difficulty doing foot hygiene due to physical or mental decline such as body habitus, poor vision, arthritic problems to mention a few.¹ The presence of PAD creates an increased risk of foot ulcers, leg/foot infection and lower extremity amputation, especially in diabetic patients. PAD is often asymptomatic;² however PAD prevalence increases with age, the majority of which occurs over age 65.³ African-American and Native Americans have approximately twice the prevalence of PAD than that of non-Hispanic Whites.⁴ There is a 40% rate of death at 5 years following the development of a foot ulcer in PAD patients.⁵ Foot ulcers require increased medical office visits, increased resource utilization, increased patient anxiety/depression and reduced quality of life (QOL).⁶ However, routine foot examinations and educating patients and their families in proper footcare can detect common foot problems, uncover functional decline and PAD, and prevent falls. In patients at-risk for foot ulcers, a yearly comprehensive foot evaluation can prevent foot ulcers, foot pain, and lower extremity amputation. Evaluation and early recognition of PAD can reduce morbidity and mortality.^6,8,13