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行動功能指標「日常生活功能」及「工具性日常生活功能」預測台灣老年人跌倒風險之探討

Predicting the Risk of Falling Based on ADLs and IADLs in Older Taiwanese

摘要


Objectives: To determine the association between functional ability as indicated by ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living) and the risk of falling in older Taiwanese. Methods: Data were drawn from the 2003 and 2007 datasets of ”The Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were 3778 participants who completed both surveys. Logistic regression analysis was employed to determine the association of ADL and IADL status with the risk of falling in 2003 and 2007 after controlling for demographic, lifestyle and health-related variables. Results: In cross-sectional analysis, IADLs but not ADLs were significantly associated with the risk of falling during the prior year. Those who had 1-2, 3-4 or 5-6 dependencies in 2007 had 1.49 (1.17-1.89, p<0.001), 1.71 (1.20-2.25, p<0.003) and 2.10 (1.31-3.38, p<0.002) times the risk of falling, respectively, during the previous 12 months when compared to those who had no dependency. Mild (1-2 dependencies) or moderate (3-4 dependencies) ADL dependency was not associated with the risk of falling and severe (5-6 dependencies) ADL impairment was negatively associated with the risk of falling. Longitudinal analysis showed that neither IADLs nor ADLs could predict the risk of falling four years later. Conclusions: Results suggested that IADL but not ADL status predicted the current or near term risk of falling; however, neither was a predictor of the risk four years later. These results highlight the importance of maintaining the functional ability of the elderly through regular exercise, proper nutrition, and routine monitoring of functional status. (Taiwan J Public Health. 2012; 31(1):21-30)

並列摘要


Objectives: To determine the association between functional ability as indicated by ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living) and the risk of falling in older Taiwanese. Methods: Data were drawn from the 2003 and 2007 datasets of ”The Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were 3778 participants who completed both surveys. Logistic regression analysis was employed to determine the association of ADL and IADL status with the risk of falling in 2003 and 2007 after controlling for demographic, lifestyle and health-related variables. Results: In cross-sectional analysis, IADLs but not ADLs were significantly associated with the risk of falling during the prior year. Those who had 1-2, 3-4 or 5-6 dependencies in 2007 had 1.49 (1.17-1.89, p<0.001), 1.71 (1.20-2.25, p<0.003) and 2.10 (1.31-3.38, p<0.002) times the risk of falling, respectively, during the previous 12 months when compared to those who had no dependency. Mild (1-2 dependencies) or moderate (3-4 dependencies) ADL dependency was not associated with the risk of falling and severe (5-6 dependencies) ADL impairment was negatively associated with the risk of falling. Longitudinal analysis showed that neither IADLs nor ADLs could predict the risk of falling four years later. Conclusions: Results suggested that IADL but not ADL status predicted the current or near term risk of falling; however, neither was a predictor of the risk four years later. These results highlight the importance of maintaining the functional ability of the elderly through regular exercise, proper nutrition, and routine monitoring of functional status. (Taiwan J Public Health. 2012; 31(1):21-30)

參考文獻


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行政院衛生署國民健康局:中老年身心社會生活狀況長期追蹤調查系列調查簡介。http://www.bhp.doh.gov.tw/BHPnet/Portal/Them_Show.aspx?Subject=200712270002&Class=2&No=200712270015。引用2010/06/25。Bureau of Health Promotion, Department of Health, Executive Yuan, R.O.C. (Taiwan). Survey of health and living status of the elderly in Taiwan: qusetionnaire and survey design. Available at: http://www.bhp.doh.gov.tw/BHPnet/Portal/Them_Show.aspx?Subject=200712270002&Class=2&No=200712270015. Accessed June 25, 2010.

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