Shoe design for older adults: Evidence from a systematic review on the elements of optimal footwear

Due to changes in foot morphology and the occurrence of foot deformities and foot pain with ageing, older people frequently wear ill-fitting shoes. This can lead to negative effects on comfort and mobility. A review of the literature was performed in Medline, Scopus and Embase with the aim (a) to evaluate the effects of shoes or shoe elements on comfort and mobility of older adults, (b) to summarise the evidence-based elements for a safe and comfortable shoe for older adults, and (c) from that, to compile those elements into design recommendations for a safe and comfortable shoe for older adults. Safe elements of footwear include proper anatomical fit, a well-fitting toe box, limited heel height, a broad enough heel, a firm insole and midsole, an outsole with sufficient tread, bevelled heel, firm heel counter with snug fit, and an easy and effective closing mechanism. We conclude that there is a need for shoe design specifically aimed at the foot morphology and demands of older people. The current shoe market should provide better availability of well-fitting shoes designed for the older foot and person.