Plummer E S, Albert S G
Department of Internal Medicine, St. Louis University Health Science Center, St. Louis, Missouri 63104, USA.
J Am Geriatr Soc. 1996 Mar;44(3):310-3. doi: 10.1111/j.1532-5415.1996.tb00921.x.
The purpose of this study was to investigate the prevalence and characteristics of foot problems in non-diabetic individuals compared with those in a diabetic population in order to develop recommendations for preventive foot care in older people.
Retrospective review of a convenience sample of all patients referred to a Foot Care Service during a 24-month period.
University Health Sciences Center.
A total of 308 patients aged 33 to 95 years (176 women and 132 men), of whom 183 had diabetes mellitus (DM) and 125 were without DM.
Each subject had a detailed history of foot care behavior and a thorough foot examination for peripheral neuropathy (PN), peripheral vascular disease (PVD), and foot deformities. PN was evaluated using the Semmes-Weinstein monofilament test. PVD was graded by clinical measures and Doppler examination (ankle:brachial index < 0.8).
Forty-three percent of subjects with diabetes had PN, 32% had PVD, and 19% had both conditions. Eighteen percent of subjects without diabetes had PN, 21% had PVD, and 6% had both. The risk of foot abnormalities in those without DM increased with age (r = .99, P = .0002). Thirty-eight percent of non-diabetic patients older than age 60 had one or more of these major risk factors and would be considered at high risk for the development of foot ulcers or amputation. Ninety percent of the subjects reported inappropriate foot care practices. Forty-seven percent of non-diabetic individuals with PN or PVD wore inappropriate shoes.
Older individuals without DM are at high risk for foot-related disease and should receive the same foot care screening, education, and follow-up as those with DM. Older people who have PN, PVD, or physical and psychosocial limitations, may require referral to foot care specialists.
本研究旨在调查非糖尿病个体与糖尿病患者足部问题的患病率及特征，以便为老年人预防性足部护理制定建议。
对在24个月期间转介至足部护理服务中心的所有患者的便利样本进行回顾性研究。
大学健康科学中心。
共有308名年龄在33至95岁之间的患者（176名女性和132名男性），其中183人患有糖尿病（DM），125人无糖尿病。
每位受试者都有详细的足部护理行为史，并接受了针对周围神经病变（PN）、周围血管疾病（PVD）和足部畸形的全面足部检查。使用Semmes-Weinstein单丝试验评估PN。通过临床测量和多普勒检查（踝肱指数<0.8）对PVD进行分级。
43%的糖尿病受试者患有PN，32%患有PVD，19%同时患有这两种疾病。18%的非糖尿病受试者患有PN，21%患有PVD, 6%同时患有这两种疾病。无糖尿病者足部异常的风险随年龄增加而增加（r = 0.99，P = 0.0002）。年龄超过60岁的非糖尿病患者中有38%具有一种或多种这些主要危险因素，被认为发生足部溃疡或截肢的风险很高。90%的受试者报告有不适当的足部护理习惯。47%患有PN或PVD的非糖尿病个体穿着不合适的鞋子。
无糖尿病的老年人患足部相关疾病的风险很高，应接受与糖尿病患者相同的足部护理筛查、教育和随访。患有PN、PVD或存在身体和心理社会限制的老年人可能需要转诊至足部护理专家处。
