"Falls in older people are an incredibly common event," says Dr. Marian Hannan, the study's senior author and associate professor of medicine at Harvard Medical School. According to the federal Centers for Disease Control, 40 percent of people aged 65 and older fall each year, often with life-altering consequences.
Bare feet, slippers and socks-only have a range of problems, Hannan explains. Slippers and socks don't offer traction or support — "they don't call them slippers for nothing," she says — and if your ankle gives way you're likely to fall. "Between no support and no traction, you're setting yourself up for failure."
Sneakers can provide valuable feedback to the wearer about balance and foot position. "Shoes are a natural extension of people's feet and they have a lot to do with how good or bad your balance is."
Previous foot/shoe studies have shown that more than 20 percent of the elderly don't wear shoes around the house and that slippers are most popular among that group. Other studies have shown that the risk of falling increases when the elderly go barefoot or wear socks without shoes, and that going barefoot adversely affects balance.
In this study, people were asked what they usually wear at home on their feet. Of the 765 people in the study, 10 percent said they were in the barefoot/socks/slippers category (about 8 percent wore slippers and 1 percent each went socks-only or barefoot). The rest wore loafers or oxfords (21 percent and 26 percent each), 36 percent wore sneakers, while the rest wore sandals, high heels or boots.
Of the 563 falls at home that occurred during the study period, half were suffered by the barefoot/slipper/sock group. (There were 1,647 falls reported by 485 participants overall.) Falls took place all over the house — bathroom, stairs, kitchen, living room — not just in wet, slippery areas.
Besides suffering the most falls, the barefoot/slipper/sock group also reported more serious injuries, such as fractures, sprains, dislocations and pulled or torn muscles, ligaments and tendons.
"I knew it would be bad to wear slippers," says Hannan, "but even people going barefoot have a lot more falls, and that was surprising to me."
Athletic shoes are ideal because more of the shoe has contact with the ground, which gives more information to your brain and allows for better balance.
"Falling's a major public health concern," she says, "so from a public health point of view, if we can do lots of small interventions, such as wearing shoes, we may prevent falls and make life better."
How to avoid falls
- Wear your glasses/get your vision checked.
- Have good lighting in your home.
- Remove scatter rugs and other objects in your walking path to avoid tripping.
- If you get up in the middle of the night, put on your glasses.
- Review medications with your doctor for interactions and side effects, such as poor balance/dizziness.
- Use a cane, walker or other device if needed to prevent falls.
- Use exercise and gentle strength training to improve leg strength, balance, and confidence in moving and walking.