Optimal shoe design for older adults

Dr KK Aggarwal

Due to changes in foot morphology and the occurrence of foot deformities and foot pain with aging, older people frequently wear ill-fitting shoes leading to discomfort and reduced mobility, says a review of literature published in the September 2019 issue of the journal Maturitas.

Anton Jellema of Faculty of Industrial Design Engineering, Delft University of Technology in the Netherlands and colleagues concluded that there is a need for shoe design specifically aimed at the foot morphology and demands of older people, including aesthetics. Shoes need to provide stability, also in the lateral direction.

The review examined the effects of shoes or shoe elements on the comfort and mobility of older adults, to summarize the evidence-based elements of a safe and comfortable shoe for older adults and from that, to compile those elements into design recommendations for a safe and comfortable shoe for older adults.

Based on the evidence, the following design recommendations were made for the shoe elements required for a comfortable and safe shoe for older adults

An optimal shoe for older adults should include the following elements:

·         A proper anatomical fit

·         A well-fitting toe box

·         A limited heel height

·         A broad enough heel

·         A firm insole and midsole

·         An outsole with sufficient tread and width

·         A bevelled heel

·         A bevelled shoe nose

·         A firm heel counter with snug fit

·         An easy and effective closing mechanism

(Source: Maturitas, September 2019, Volume 127, Pages 64–81)

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA

Loneliness in older adults: A new epidemic of society

Loneliness is the new epidemic of society today. Loneliness is particularly common in older adults, whose children have grown up and left the nest and are busy with their lives.

The amygdala in the brain plays a key role in regulating emotions and emotional responses.  The dorsal posterior insula regulates perception of pain; it becomes more active when we are lonely, so anything that happens to socially isolated people is more painful.

Cortisol is the fight or flight hormone. Oxytocin along with serotonin and dopamine constitute the happy hormones. Increase in dopamine, serotonin and oxytocin increase the positive emotions in the body.

Brain derived neurotrophic factor is another chemical, which helps the brain to remain plastic, or flexible, so that we can continue to hold on to past memories and create new ones. This chemical is present in low amounts in socially isolated people.

Loneliness is harmful socially; it is also bad for health, a fact which has been corroborated in studies. Loneliness is a strong predictor of heart disease, stroke or premature death.

A new article published April 29, 2019 in the Canadian Medical Association Journal has addressed the effect of loneliness on older patients. As per the article, loneliness is:

·         an emotional state of perceived isolation; it is not a mental disorder

·         common in older adults and linked to declines in health

·         as harmful as other risk factors for death, such as obesity and smoking

·         a significant predictor of health care usage

·         possibly alleviated by "social prescribing" to connect lonely adults with community supports and social networks

Dr KK Aggarwal

Padma Shri Awardee

President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)

Group Editor-in-Chief IJCP Publications

President Heart Care Foundation of India

Past National President IMA