台灣老人成功與活躍老化之健康餘命探討

Healthy Life Expectancy for Successful Aging and Active Aging Elderly in Taiwan

林正祥(Cheng-Hsiang Lin) ； 劉士嘉(Shih-Chia Liu)

《台灣公共衛生雜誌》 32卷6期 (2013/12) Pp. 562-575

https://doi.org/10.6288/TJPH201332102078

摘要

目標：基於生命質的改善和量的增加同等重要，對老人健康之關注，不應侷限於以往罹病或功能障礙老人之照顧，而是積極提升其整體生活品質及安適狀態為目標，即「成功老化」與「活躍老化」的概念。不論成功老化或活躍老化，均同時涵蓋老年人身體、心理、社會三個面向。本研究旨在探討台灣老年人口在成功老化及活躍老化之變遷及可能影響因素。方法：利用國民健康署所建立之「台灣地區中老年人身心社會狀況長期追蹤研究調查」資料，依成功老化與活躍老化定義，就老人成功、活躍老化變動趨勢，以馬可夫鏈模式軟體IMaCh（interpolatedMarkov chain，IMaCh）推算60歲以上老人世代平均餘命，成功、活躍老化健康餘命及各年齡盛行率；另亦就高血壓、心臟病及糖尿病等重要慢性疾病探討其對成功、活躍老化健康餘命影響差異。結果：影響成功老化、活躍老化之各組成項目（ADL、IADL、無憂鬱症狀、認知功能正常、良好社會支持、具生產力）正常百分比大致隨著年齡增長而逐年下降，成功老化及活躍老化盛行率亦呈現相同趨勢；平均餘命方面，成功老化健康餘命佔平均餘命約四至五成間，其中活躍老化在15%～25%間。三種慢性疾病中，糖尿病成功、活躍老化健康餘命百分比在各年齡組均較高血壓及心臟病為低。結論：提升活躍老化應是有關單位努力的理想目標；在慢性疾病上，以糖尿病的負面影響最為明顯，相對於其他慢性疾病，糖尿病的防治有極大的改善空間。

關鍵字

成功老化 ； 活躍老化 ； 健康餘命 ； 馬可夫鏈

並列摘要

Objectives: Improvements in the quality and quantity of life are equally important based on the concepts of successful aging and active aging. These include physical, mental and social well-being in old age. Instead of the past emphasis on improving morbidity or malfunction, the goal for health care of the elderly should focus on actively improving their comfort and overall quality of life. Methods: In order to explore the factors affecting the long term changes in the trends of successful aging and active aging of older people in Taiwan, we analyzed the data from a survey of Health and Living Status of the Elderly in Taiwan conducted by the Health Promotion Administration, Ministry of Health and Welfare. Using the interpolated Markov chain approach, we projected the prevalence and healthy life expectancy. We also investigated the effects of chronic diseases e.g. hypertension, heart disease and diabetes on the differences in healthy life expectancy, successful aging, and active aging. Results: The influence of variables which positively affected successful aging and active aging declined as age increased. Similar results were observed for prevalence. For successful aging, healthy life expectancy accounted for approximately 40-50% of all life expectancy; of this, active aging accounts for about 15-25%. For each age group, diabetes lowered the percentage of healthy life expectancy compared to hypertension and heart disease. Conclusions: Achieving a high quality of active aging is an ideal goal for the government and health institutes. Among chronic diseases, diabetes had the most serious impact on healthy life expectancy and its prevention and treatment should be emphasized.

並列關鍵字

successful aging ； active aging ； healthy life expectancy ； Markov chain

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