Mobility Performance in Older Adults at Different Levels of Health and Independence

居住於社區、照顧住宅及護理之家老人的健康狀態及活動表現

王靜怡(Ching-Yi Wang) ； 葉志嶸(Chih-Jung Yeh) ； 許清芳(Ching-Fan Sheu)

《中山醫學雜誌》 21卷2期 (2010/06) Pp. 145-159

https://doi.org/10.30096/CSMJ.201006.0003

摘要

目的：本研究目的為使用臨床常用的身體表現測試以評估不同健康及獨立狀態的老人（居住於社區、照顧住宅及護理之家中老人）之表現，結果指標為依年齡調整後之平均值及平均值之95%信賴區間，作為臨床解讀測試結果時的初步參考依據。
方法：共有648位，年滿60歲，自願參與本研究（366位來自社區、209位來自照顧住宅、73位來自護理之家），所有參與者都接受健康狀態及活動相關的身體表現檢測。健康狀態包括：慢性病總數、身體質量指數、自覺健康狀態、憂鬱程度、心智功能、及失能狀態。身體表現以八項測試評估：手握力、計時坐站、功能性伸取、一般及快速步行速度、計時起走、六分鐘走及伯格式平衡量表。
結果：以居住於社區中的老人有最佳的健康及獨立狀態的表現及最年輕，其次為居住於照顧住宅的老人，最差的是居住於護理之家的老人。以2008年台灣老人人口為標準化人口，計算年齡調整的平均值及其95%信賴區間，並針對三組老人中男性及女性分別報告。功能性伸取及計時起走為最多護理之家中長輩無法執行的表現測試。
結論：此八項功能檢測的年齡調整之平均值及其95%信賴區間，可作為臨床人員使用此測試評估老人身體表現時，用以解釋測試結果的初步參考依據。

關鍵字

身體表現 ； 老人 ； 社區 ； 照顧住宅 ； 護理之家

並列摘要

Purpose: The aim of this study was to assess mobility related physical function of older adults at different levels of health status and independence living in the community, assisted living facilities, and nursing homes using eight well-known performance tests in order to set a bench mark on the continuum of older adults’ performance on these tests for clinical reference.
Methods: 648 older adults(≥60 years of age) were studied: 366 residing in the community, 209 in assisted living facilities, and 73 in nursing homes. All participants received health status and performance tests. Heath status assessment included number of comorbidities, body mass index, self-perceived health status, depression, mental status, and physical disability status. Physical function was assessed using eight standard performance tests: grip strength, timed chair stand, functional reach, usual & fast gait speed, timed up & go, six-minute walk, and the Berg Balance Scale.
Results: Community dwelling residents exhibited the best overall health and performance and were youngest in age, followed by the assisted living and then the nursing home residents. Age-adjusted means and 95% confidence intervals for each of these tests for each of the groups by gender can be used as benchmarks of health and independence. Most older nursing home residents could not perform the FR and TCS.
Conclusions: The age-adjusted means and 95% confidence intervals reported for the eight performance tests in this study can facilitate better interpretation of the tests used to assess mobility-related function in older adults.

並列關鍵字

physical performance ； elderly ； community ； assisted living ； nursing home