Restricted mobility in nursing home residents: The role of pain and cognitive capacity

Abstract

Background: Pain, restriction of mobility and cognitive impairment are often present in old age and intensify each other. Objectives: Is there a relationship between mobility, pain, cognitive capacity, diagnoses and number of prescribed medication for residents of nursing homes? Methods: Subgroup analysis of the baseline data from an intervention study for optimization of the medication safety of 120 nursing home residents. Results: Pain was presumed in 77.8% of the residents. Persons with cognitive impairment were more frequently affected. The results of the observational and self-reported pain assessment in cognitively impaired patients did not agree for two-thirds of the cases. A correlation between prevalence of pain, pain intensity and mobility could only be shown for persons without cognitive impairment. Half of the persons were unable to walk; 80% of the residents with analgesics as a permanent medication were more restricted in their mobility. Conclusions: Cognitive impairment is associated with pain and reduced mobility, whereby self-rated pain did not concur with the observational pain assessment for two-thirds of the residents with cognitive impairment. This illustrates the difficulty of observational pain assessment.