高齡者的失能預防

Prevention of Disability in the Elderly

陳喬男(Joyce Chiao-Nan Chen)

《長期照護雜誌》 19卷2期 (2015/09) Pp. 149-155

https://doi.org/10.6317/LTC.19.149

摘要

隨著高齡人口逐漸增加，了解造成高齡者失能的原因及其預防方法至為重要，其將有助高齡者維持體能活動能力，得以扮演在家庭社會之角色。高齡者的失能與身體的衰弱程度緊密相關。身體之衰弱常表現在自覺之疲憊感、肌肉無力、體能活動力下降，以及疾病抵抗能力下降。老化、疾病及缺乏運動是造成個體衰弱的主因。老化伴隨之骨骼肌質量與力量的下降，導致高齡者走路速度變慢、跌倒機率增加、獨立生活能力下降，並增加高齡者入住養護機構的比例。阻力型運動，配合足夠之蛋白質攝取，為增加高齡者骨骼肌質量的黃金處方。另外，與老化相關之疾病，如心臟病、中風、退化性關節炎、與跌倒造成之骨折常降低高齡者活動的意願與能力。飲食及多面向運動可有效改善高齡者身體代謝異常的情形，並增加其骨質密度與平衡能力，有效預防老化相關疾病的發生。總結來說，適當的飲食與運動可增加高齡者具備獨立生活能力的壽命，減少其失能的時間，達到增加個體與照顧者生活品質的目標。

關鍵字

失能 ； 老年人 ； 運動 ； 飲食 ； 預防

並列摘要

Disability is the term describing the impairment of body function of individuals that limits the activities that they can perform and restricts the participation that they can involve in the life. As the elderly population rises continuously, it is important to understand the causes of the disability in the elderly and the strategies to prevent it. Frailty characterized by slow walking speed, muscle weakness, feeling exhaustion, decreased physical activity and loss of lean body mass is the major cause of disability in the elderly. Risk factors of frailty are age, diseases and lake of exercise. Age-related loss of muscle mass and strength is the central and paramount factor of frailty in the elderly. Progressive resistance exercise accompanied with sufficient protein intake effectively increase muscle strength and lean body mass of the elderly. Age-related diseases such as heart diseases, stroke, osteoarthritis and fall-related fracture also decrease the exercise capacity of the elderly and negatively affect the willingness of individuals to exercise. Multidimensional exercises and diet intervention including calorie restriction and vitamin D supplementation not only increase physical function and reduce fall incidences of the elderly but also improve metabolic impairment that is associated with age-related diseases. In conclusion, adequate diet strategies and exercise regimen play an important role to prevent or postpone the disability in the elderly.

並列關鍵字

Disability ； elderly ； exercise ； diet ； prevention

參考文獻

Anderson, G. L., Judd, H. L., Kaunitz, A. M., Barad, D. H., Beresford, S. A., Pettinger, M., … Lopez, A. M. (2003). Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: The women's health initiative randomized trial. The Journal of the American Medical Association, 290(13), 1739-1748. doi:10.1001/jama.290.13.1739

Anton, S. D., Karabetian, C., Naugle, K., & Buford, T. W. (2013). Obesity and diabetes as accelerators of functional decline: Can lifestyle interventions maintain functional status in high risk older adults? Experimental Gerontology, 48(9), 888-897. doi:10.1016/j.exger.2013.06.007

Bauer, J., Biolo, G., Cederholm, T., Cesari, M., Cruz-Jentoft, A. J., Morley, J. E., …Boirie, Y. (2013). Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group. Journal of the American Medical Directors Association, 14(8), 542-559. doi:10.1016/j.jamda.2013.05.021

Beenakker, K. G., Ling, C. H., Meskers, C. G., de Craen, A. J., Stijnen, T., Westendorp, R. G., & Maier, A. B. (2010). Patterns of muscle strength loss with age in the general population and patients with a chronic inflammatory state. Ageing Research Reviews, 9(4), 431-436. doi:10.1016/j.arr.2010.05.005

Fiatarone, M. A., O'Neill, E. F., Ryan, N. D., Clements, K. M., Solares, G. R., Nelson, M. E., …Evans, W. J. (1994). Exercise training and nutritional supplementation for physical frailty in very elderly people. New England Journal of Medicine, 330(25), 1769-1775. doi:10.1056/NEJM199406233302501