title: Mobility is the key! Trends and associations of common care problems in German long-term care facilities from 2008 to 2012.
abstract: BACKGROUND
  Although enormous efforts have been made in auditing the quality of care, there are only few epidemiological studies available about the actual occurrence of immobility, malnutrition, urinary incontinence, cognitive impairment, falls and pressure ulcers in long-term care facilities.
  
  
  OBJECTIVE
  The objective of this study was to provide prevalence estimates of common nursing care problems in long-term care facilities and to investigate any associations between them.
  
  
  METHODS
  Secondary data analysis of five consecutive annual cross-sectional multicenter studies from 2008 to 2012.
  
  
  METHODS
  262 different long-term care facilities throughout Germany.
  
  
  METHODS
  14,798 residents older than 18 years who gave informed consent.
  
  
  METHODS
  Health conditions were rated based on direct resident examinations according to the current international definitions. Demographic characteristics were compared with available national population statistics. Apart from descriptive statistics, Chi(2) tests were carried out for bivariate and log-regression models were performed for multivariate associations.
  
  
  RESULTS
  Prevalence rates were stable over the years with the highest prevalence of 73.5% (95% CI 72.8-74.2) being found for urinary incontinence, for cognitive impairment it was 54.1% (95% CI 53.3-54.9) and for immobility it was 36.5% (95% CI 35.7-37.3). The lowest prevalence rates were established for the risk of malnutrition with 13.0 (95% CI 12.4-13.5), for pressure ulcers with 4.8% (95% CI 4.5-5.1) and for falls (4.4% 95% CI 4.1-4.8). In the multivariate model, immobility was most strongly associated with all of the other conditions. No statistically significant associations were found between pressure ulcers and falls, pressure ulcers and urinary incontinence, pressure ulcers and cognitive impairment and between malnutrition and urinary incontinence.
  
  
  CONCLUSIONS
  Decision-makers and clinical practitioners may primarily focus on the maintenance and enhancement of mobility, because this seems to be the key predictor for many other health conditions in the context of care dependency in the nursing home setting.
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany. Electronic address: nils.lahmann@charite.de.
authors.forename: Nils A
authors.initials: NA
authors.lastname: Lahmann
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Antje
authors.initials: A
authors.lastname: Tannen
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Simone
authors.initials: S
authors.lastname: Kuntz
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Raeder
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Schmitz
authors.affiliation: Department of Nursing Science, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Theo
authors.initials: T
authors.lastname: Dassen
authors.affiliation: Clinical Research Center for Hair and Skin Science, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Kottner
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005858:Germany; D006801:Humans; D008134:Long-Term Care; D008875:Middle Aged; D009735:Nursing Homes / Q000458:organization & administration*; D011787:Quality of Health Care; D016138:Walking
keywords: Cognitive impairment; Falls; Long-term care facilities; Malnutrition; Mobility; Pressure ulcers; Urinary incontinence