Intrinsic Risk Factors

Intrinsic risk factors for pressure ulcer development include age, conditions that impair mobility, malnutrition, and sensory impairment. Skin changes associated with aging (e.g., epidermal thinning, diminished vascularity) increase the susceptibility of older persons to shearing forces, pressure, and friction. Immobility can cause infrequent position changes, thus exposing an older person to prolonged pressure. Malnutrition, specifically an inadequate intake of calories or protein, has been associated with the development of pressure sores (Thomas, 2001). AHCPR (1994) defines clinically significant malnutrition as a serum albumin level of less than 3.5 mg/dL, a total lymphocyte count of less than 1800 cells/ mm3, or body weight less than 80% of ideal weight. Supplementation of micronutrients involved in skin healing, such as ascorbic acid and zinc, has not been shown to prevent pressure sores or improve rates of healing. Sensory impairment, such as in diabetic neuropathy, can prevent an individual from responding appropriately to pressure-related discomfort (Patterson and Bennett, 1995; Reddy et al., 2006; Thomas, 1997, 2001).

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