Outcomes and healing of neuropathic foot ulcers in the elderly

A study which set out to evaluate neuropathic ulcers in the elderly has demonstrated that they can heal despite age-related skin changes if standard foot care is given in a multi-disciplinary foot service.

The research provides a “benchmark” for healing outcomes, the authors say, and enables comparison with other age groups and centres.

The findings have also highlighted a risk of falls associated with off-loading devices, identifying the need for structured falls risk and mobility assessments in this group.

Historically, there is little evidence on healing outcomes of neuropathic foot ulcers in elderly patients.

This prompted the study by Peter Lamont, Helena Meally and David A Russell from Leeds Teaching Hospitals NHS Trust, Emma Drydon from Calderdale and Huddersfield NHS Foundation Trust and Anjali Santhakumar from Manchester University Foundation Trust.

The team set out to determine the healing rates of neuropathic diabetic foot ulcers at 12 and 24 weeks achieved by standard care provided at an established multidisciplinary diabetes foot clinic in patients aged 65 years and above. Hypoglycaemia and falls data were also collected.

This retrospective observational study was made up of patients aged 65 years or more presenting with a non-infected neuropathic ulcer at the time of their initial review. They were classified into two groups: Group E patients were aged above 80 years and Group Y patients 65-80 years.

A total of 97 patients, presenting with 106 ulcer episodes, were identified.

The research team reported the following results: Mean HbA1c was 60 mmol/mol in Group Y and 55 mmol/mol in Group E. Healing rates of all ulcers at 12 and 24 weeks in the elderly group lagged behind rates in the younger group (67.6% at 12 weeks and 73% at 24 weeks in Group E vs. 78.2% at both intervals in Group Y).

“The elderly group had more falls, 11% vs. 2% in Group Y. In all, 50% of the falls in Group E were attributed to their prescribed pressure relief (off-loading) devices.”

Photo by Pixabay from Pexels

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