title: Inactive Residents Living in Nursing Homes and Associated Predictors: Findings From a Regional-Based, Italian Retrospective Study.
abstract: It has been amply reported that nursing home (NH) residents are largely inactive, a condition that may further increase functional decline, behavioral disorders, and risk of death. To date, studies have mainly focused on individual characteristics that may decrease residents' involvement in activities. Therefore, the aim of this study is to describe the prevalence of inactive NH residents in an Italian context, identifying predictors of inactivity at the individual and NH levels.
  
  
  
  Retrospective regional-based study performed in 2014.
  
  
  
  All NHs (n = 105) located in the Friuli Venezia Giulia Region, northeastern region of Italy.
  
  
  
  A total of 8875 residents with at least 1 nursing assessment and living in an NH for at least 1 year.
  
  
  
  The dependent variable was inactivity in the last week, defined as the resident not being involved in any socially or individually based, or meaningful recreational (eg, gardening) activities. The independent variables were set at individual and NH levels. Aiming at identifying predictors of inactivity, a hierarchical generalized linear (mixed-effects) model incorporating both fixed-effect parameters and random effects, was performed.
  
  
  
  A total of 4042 (45.6%) residents were inactive during the week before the evaluation. At the resident level, those with severe cognitive impairment [odds (OR) 4.462, 95% confidence interval (CI) 3.880-5.132], unsociable behavior (OR 2.961, 95% CI 2.522-3.473), night restlessness (OR 1.605, 95% CI 1.395-1.853), lack of cooperation in daily care (OR 1.408, 95% CI 1.199-1.643), pressure sores (OR 1.314, 95% CI 1.065-1.622), depressive disorders (OR 1.242, 95% CI 1.089-1.416), and clinical instability (OR 1.110, 95% CI 1.037-1.188) reported an increased risk of being inactive. At the NH level, for each additional hour of care offered by professional educators, there was 1% less likelihood of inactive residents (OR .964, 95% .933-.996).
  
  
  
  Approximately one-half of the residents in this study living in Italian NHs are inactive. Inactivity is significantly associated with the presence of severe cognitive impairment, behavioral disorders (eg, unsociability, night restlessness, and lack of cooperation in daily care), pressure sores, depressive symptoms, and clinical instability. Moreover, receiving care from professional educators whose aim in their training program and professional mission is to improve individual and social engagement, decreased the likelihood of resident inactivity.
authors: Department of Medical Biological Sciences, University of Udine, Udine, Italy. Electronic address: alvisa.palese@uniud.it.
authors: Alvisa
authors: A
authors: Palese
authors: Department of Medical Biological Sciences, University of Udine, Udine, Italy.
authors: Carolina
authors: C
authors: Del Favero
authors: Welfare Unit, Friuli Venezia Giulia Region, Italy.
authors: Ranieri
authors: R
authors: Antonio Zuttion
authors: Welfare Unit, Friuli Venezia Giulia Region, Italy.
authors: Barbara
authors: B
authors: Ferrario
authors: Welfare Unit, Friuli Venezia Giulia Region, Italy.
authors: Sandra
authors: S
authors: Ponta
authors: Department of Economics and Statistics, University of Udine, Udine, Italy.
authors: Luca
authors: L
authors: Grassetti
authors: School of Nursing, University of Verona, Verona, Italy.
authors: Elisa
authors: E
authors: Ambrosi
mesh_terms: D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007558:Italy; D007899:Leisure Activities; D016014:Linear Models; D008297:Male; D009735:Nursing Homes; D015995:Prevalence; D012189:Retrospective Studies; D057185:Sedentary Behavior
keywords: Inactivity; hierarchical generalized linear mixed-effects model; leisure activities; long-term residents; nursing home; predictors; residents; retrospective study