I'm really concerned about my mother. She thinks she's some kind of fashion queen. But at age 77, we think her high-heeled slippers and fashion shoes are going to be the cause of a bad fall. What can we do to help her wear something more reasonable on her feet?

Shoe wear can be an extremely important item of clothing in the older adult -- and not just from a sense of fashion. Studies show that almost half of all falls are linked with the type of shoes worn at the time of the fall.

Slippers and heels double the risk of falling in older people. Combining slippers with high heels hasn't been investigated. But even younger adults are at risk of fractures from shoes with a high or narrow heel. And walking barefoot isn't any better. The risk of falling also increases with bare feet (and especially wearing just socks).

Most older adults fall when their balance is challenged, and they can't regain their center-of-balance. A recent study of shoe type has shown the benefit of a comfortable, low top, lace-up Oxford shoe. They may not be the height of fashion, but they will reduce the risk of falls and disabling fractures in anyone 65 or older.

Sharing these statistics may help your mother appreciate the seriousness of the problem for all older adults. But she may respond more favorably if she hears it from a valued friend or trusted health care professional.

You may want to consider discussing your concerns with people in both these categories and see what happens. Hopefully, with education on this point, more older adults will modify their shoe wear before a fall leads to a traumatic injury.