Foot Function in Older Adults: An Overlooked Determinant of Independent Living and Fall Prevention

OBJECTIVES With the rapid aging of the population, maintaining independent living and preventing falls in older adults have become critical public health concerns. While conventional fall prevention strategies have primarily focused on lower extremity strength and balance, the functional role of the foot-which serves as the primary interface between the body and the ground-has been relatively overlooked. This narrative review aims to examine age-related changes in foot function and to investigate how sensory, structural, and muscular components of the foot influence balance, gait, and independent mobility in older adults.METHODS A narrative review was conducted using literature published since 2000, retrieved from databases including PubMed, Scopus and Google Scholar. Studies addressing age-related changes in foot function, foot-related assessments, and intervention strategies were included. The review synthesized findings across sensory function, structural alignment, joint mobility, and muscular strength, and further examined integrative training approaches targeting foot function.RESULTS The findings indicate that age-related declines in plantar sensory function, structural deformities such as hallux valgus and reduced medial longitudinal arch, and decreased intrinsic and extrinsic foot muscle strength are significantly associated with impaired balance, reduced gait efficiency, and increased fall risk. In addition, limitations in hallux metatarsophalangeal joint mobility were found to negatively affect push-off mechanics during gait. Multidimensional assessment of foot function was shown to be essential for identifying functional deficits. Furthermore, stepwise intervention strategies including sensory re-education, mobility training, muscle strengthening, and integrated functional training-demonstrated potential in improving postural control and functional mobility.CONCLUSIONS Foot function plays a fundamental role in maintaining balance, gait efficiency, and independent mobility in older adults. These findings suggest that foot function should be considered a key component in fall prevention and rehabilitation strategies. A multidimensional assessment approach combined with a staged, integrative training model may provide an effective framework for enhancing functional independence in older populations. Future research should focus on establishing standardized assessment protocols and conducting randomized controlled trials to verify the independent effects of foot-targeted interventions.