台灣老人身體活動能力與日常生活功能之階層相關探討

The Hierarchical Relationship between Mobility Limitation and ADL Disability in Older Taiwanese Persons

葉婷婷(Ting-Ting Yeh) ； 王靜怡(Ching-Yi Wang) ； 林志峰(Chin-Feng Lin) ； 陳惠雅(Hui-Ya Chen)

《物理治療》 35卷1期 (2010/03) Pp. 1-7

摘要

背景和目的：身體活動能力和工具性、基本日常生活功能三大失能領域存在階層關係，但其詳細關聯則尚不明確。本研究描述身體活動能力與日常生活功能的相關性。方法：篩選民國九十二年台灣大型資料庫中65歲以上社區老人共2, 626位。以敘述性統計描述三大失能領域之階層關係，以曲線估計呈現身體活動能力與日常生活功能總失能項目數之相關性，以相關分析呈現身體活動能力各單項分數與日常生活功能總失能項目數之相關性。結果：身體活動能力是第一個失能的領域；當九項活動平均失能項目數分別達到四及七項時，工真性及基本日常生活功能才出現一項以上失能。九項身體活動與日常生活功能分別有不同的相關性，可分為較需下肢肌力與耐力的活動、走路與爬樓梯等活動、需上肢的活動三類。結論：三大失能領域不僅存在著先後的階層關係，身體活動能力失能與工具性、基本日常生活功能失能有著不同程度的重疊；此結果可供連續性的老人照護服務之參考。三類身體活動能力的研究結果可作為失能嚴重度分類的依據。

關鍵字

老人 ； 失能 ； 身體活動能力 ； 工具性日常生活功能 ； 基本日常生活功能

並列摘要

Background and Purpose: The disability domains of physical mobility, instrumental ADL, and basic ADL have been shown of a hierarchical relationship. Their detailed relationship, however, is yet unclear. This study aimed to describe the relationship between disabilities of physical mobility, IADL, and BADL. Methods: From a 2003 national representative database in Taiwan, 2626 community-dwelling samples aged over 65 were retrieved. We used descriptive analyses to study the sequential hierarchical relationship of the three disability domains, curve estimations to study the relationship between the number of summed disability items within each domain, and correlation tests to study the relationship between the score of single item of the mobility domain and the number of summed disability items of IADL and BADL. Results: Physical mobility is the first domain to appear during evolution of disability. Averagely when its number of summed disability items reaches four and seven, out of nine, respectively, one disability item in IADL and BADL starts to manifest. The nine mobility items have different correlations with IADL and BADL, and could be categorized into three-items requiring more leg strength and endurance, items such as walking and stairs climbing, and items relating to arms and hands. Conclusions: Disability of physical mobility has not only a sequential hierarchical relationship with ADL disabilities, but also overlaps with basic and instrumental ADL in different ways. The results may provide useful information for seamless care of older persons. The findings of three categories of physical mobility are valuable for categorization of disability severity.

並列關鍵字

Older ； Disability ； Physical mobility ； Instrumental ADL ； Basic ADL