Risk factors associated with immobility.

In nursing homes, immobility and related complications are major problems with profound health care and financial implications. We conducted a retrospective study to identify risk factors associated with immobility. We compared factors in 34 nonambulatory residents with those in 12 independent ambulatory residents who served as controls. Factors associated with immobility included contractures, severe dementia, poor vision, and history of hip/leg fractures. Factors not associated with immobility included age, osteoarthritis, mild to moderate dementia, weight gain, and broad categories of selected medications. The immobile patients were further analyzed by subgrouping into those with and without contractures. Contractures were significantly associated with severe dementia. The finding that immobility was not identified on problem lists for 85% (29) of the immobile residents and that for 29% (10) reasons for immobility could not be ascertained suggest that immobility is frequently not documented as a major problem in medical records nor adequately evaluated.