The Alzheimer's Digest: Good Shoes

I can't say I've ever seen shoes on lists of what to give mom for Mother's Day. But a good pair of shoes truly is the gift that keeps on giving. For a couple hundred miles, at least.

Before you give this idea the boot –- and I admit it's unorthodox –- consider 4 great reasons to give shoes as a gift(beyond that their boxes are super easy to wrap):

1. She probably needs them more than she thinks. Foot specialists say older adults, especially, tend to hang onto a few trusty pairs long after their sturdiness, support, and traction has worn out. One rule of thumb: Shoes worn daily are in top form only a couple of years, especially if you walk a lot. (Figure 350 to 500 miles a pair.)

2. Her health is at risk. Net result of worn or ill-fitting shoes: One in three people over 65 have foot problems, according to the American Academy of Orthopedic Surgeons (AAOS). The wrong fit can cause you to subtly shift your balance, raising your risk of falling and breaking a bone. Flimsy support and slippy heels make wearers fall-prone, too.

3. She may lack motivation to buy new shoes on her own. Contributing to the reluctance to renew shoes after a certain age: A fixed income, the weak economy, a Depression-borne "wear it til it wears out" mindset, and an already-full shoe rack (even if a pair is tattered or hasn't been worn since your wedding in 1983). And moms who don't or can't get out much may not get to a shoe store on their own.

4. You may earn points for originality!

Interestingly, last year Irish researchers reported in Age and Ageing that frail older women who wear shoes are at lower risk of falling than those who go barefoot!

So what makes a good shoe?

Proper (usually meaning larger) size. Ninety percent of women wear shoes that are too small*, according to AAOS! If you're surprising Mom, try starting with a half-size up from what's in her closet (knowing you may need to exchange). If you're taking her shoe-shopping, be sure to get a professional fitting; don't take her word she's a size 5 because she's "always been." Realize – as she may not – that there's a wide world of choices out there now for wide feet, too. (Google "wide shoes for women.")
A not-too-smooth, not-too-clunky sole. Check the bottoms. They should offer some traction, not be slick-smooth. (A shoe repair shop can add textured strips or half-soles.) However don't go the other extreme to those super-soled athletic shoes. A famous 1998 study found that 60 percent of older people who had fallen while wearing athletic shoes complained the shoe's big rubber nubbins had "caught or dragged" in the floor.
Natural materials. Synthetics are often cheaper, but leather and canvas allow feet to breathe, reducing skin irritations. Better yet: They're flexible, so they move with your feet. Less tripping, less rubbing. Man-made soles are especially slick.
The right type of comfort. Good: A fit that feels nice from the first wearing. Not-so-good: Excessive cushioning. Research shows that gym shoes and booties with pillowy padding destabilize feet, which can impair balance.
Solid support. If a shoe feels flimsy to your hands, uh, it probably is for your foot. Just to compare: A new mid-sole will crinkle when you press down on it; a worn-out old one won't give as much. New shoes shouldn't rub anywhere; old shoes may have worn-out areas on the inside.
Convenient fastenings. Lace-up shoes are ideal because they secure the shoes to the feet and can be adjusted based on sock thickness, orthotics, or time of day (feet swell in the afternoon). But for people with dexterity problems, go Velcro. If you do keep laces, make sure they're not too long – Grandmas can "trip over their laces" as easily as kids can.
Lower heel. Shoes with lower heels and wider floor contact are associated with lowest falls, according to a 2004 study in the Journal of the American Geriatrics Society. Best: No more than 1 to 1.5 inches.
Safe styles for summer. If your mom is still active and loves sandals, try getting her to trade up from flimsy flip-flops to athletic-style sport sandals with back straps. Get help at a good shoe store finding brands with built-in support. The American Podiatric Medicine Association gives Crocs its Seal of Acceptance as being comfortable for people with bunions and hammertoes.

The all-around winner: Canvas sneakers or athletic shoes. They're breathable, flexible, low, secure, and wide-soled. In one analysis of older wearers, sneakers caused fewer falls than boots, sandals, high heels, slippers, or going barefoot. Be sure to let a style-conscious mom know that sporty sneaks are fashion forward and available in more non-gym-shoe-ish styles than ever. Think Barbara Bush and her colorful collection of Keds, which are now stylish enough to be advertised by young movie stars and have hopped on the [custom-design] (http://www.keds.com/text/kedsstudio/) bandwagon.

Giving shoes as gifts also answers the dilemma of what to give moms and grandmothers who are so fond of saying they don't need anything because they have "everything." It's a rare woman who doesn't have a soft spot for new shoes -- and a rare one whose feet don't truly need them.