Prevalence and Predictors of Ambulatory Care Physicians’ Documentation of Mobility Limitations in Older Adults

Published:January 29, 2023DOI:



      To determine how often physicians document mobility limitations in visits with older adults, and which patient, physician, and practice characteristics associate with documented mobility limitations.


      We completed a cross-sectional analysis of National Ambulatory Medical Care Surveys, years 2012-2016. Multivariate analyses were conducted to identify patient, physician, and practice-level factors associated with mobility limitation documentation.


      Ambulatory care visits.


      We analyzed visits with adults 65 years and older. Final sample size represented 1.3 billion weighted visits.


      Not applicable.

      Main Outcome Measure

      We defined the presence/absence of a mobility limitation by whether any International Classification of Diseases (ICD)-9 or ICD-10 code related to mobility limitations, injury codes, or the patient's “reasons for visit” were documented in the visits.


      The overall prevalence of mobility limitation documentation was 2.4%. The most common codes were falls-related. Patient-level factors more likely to be associated with mobility limitation documentation were visits by individuals over 85 years of age, relative to 65-69 years, (odds ratio 2.32, 95% confidence interval 1.76-3.07]; with a comorbid diagnosis of arthritis (odds ratio 1.35, 1.18-2.01); and with a comorbid diagnosis of cerebrovascular disease (odds ratio 1.60, 1.13-2.26). Patient-level factors less likely to be associated with mobility limitation documentation were visits by men (odds ratio 0.80, 0.64-0.99); individuals with a cancer diagnosis (odds ratio 0.76, 0.58-0.99); and by individuals seeking care for a chronic problem (relative to a new problem [odds ratio 0.36, 0.29-0.44]). Physician-level factors associated with an increased likelihood of mobility limitation documentation were visits to neurologists (odds ratios 4.48, 2.41-8.32) and orthopedists (odds ratio 2.67, 1.49-4.79) compared with primary care physicians. At the practice-level, mobility documentation varied based on the percentage of practice revenue from Medicare.


      Mobility limitations are under-documented and may be primarily captured when changes in function are overt.


      List of abbreviations:

      ICD (International Classification of Diseases), NAMCS (National Ambulatory Care Medical Survey), PCP (primary care physician)
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      Linked Article

      • The Unrecognized Problem of Mobility Limitations Among Older Adults
        Archives of Physical Medicine and Rehabilitation
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          The “Graying of America” has been used to describe the rapid growth of the older adult population in the US. The number of adults 65 and older is expected to double from 49 million in 2016 to 95 million in 2060, representing a growth from 15% to 25% of the US population.1 Many older adults view mobility as an important component of successful aging,2 and mobility limitations have a profound effect on the physical, psychological, and social functioning of older adults.3 Mobility limitations are associated with increased risk of mortality, institutionalization, and health care utilization.
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