- 期刊
The Impacts of Widowhood, Chronic Disease, and Physical Function on Mortality among Older People
寡居、慢性病和身體功能對老人死亡率的衝擊
摘要
背景：隨著台灣年齡老化與喪偶人數的逐漸增加，喪偶老人存活率的議題值得關心。目的：旨在探討台灣地區寡居、慢性病與身體功能等因素對老人死亡風險之衝擊。方法：以長期追蹤資料來評估台灣老人死亡風險率的情形。資料來自2003年「台灣地區中老年人保健與居住狀況調查」，並配合2003到2007年間相同受訪者的官方死亡紀錄，設定觀察期間。以Cox風險比例模型分析鰥夫、寡婦、慢性病、身體功能障礙與老人存活率的關係。結果：在控制其他變數後，存活分析顯示喪偶者呈現出較高的死亡風險。其中，鰥夫的死亡風險又高於寡婦。另外，慢性病中的惡性腫瘤與中風（腦溢血）顯著的威脅已婚男、女的生命。但是，支氣管炎、肺氣腫、肺病與其他呼吸性疾病則只對男性有影響。再者，身體活動功能對死亡產生顯著的預測效果，特別是工具性日常生活活動功能。結論／實務應用：本研究確認寡居、慢性病、身體功能等與老人死亡風險息息相關。所以，本文建議應該多關心老人的這些課題，並制訂相關福利政策，以提高老人的存活率。
並列摘要
Background: Age-related physical and mental health is well documented. The numbers of widows and widowers are rising in Taiwan. Thus, it is worthwhile to consider factors affecting survival rates after the death of a spouse. Purpose: This study examined the impacts of widowhood, chronic disease, and physical function on mortality risk among the older people in Taiwan. Methods: A panel data design was applied to investigate the hazard ratio of mortality among the older people. Subject data were obtained from the 2003 Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan and linked to the 2003Y2007 national death registry data. Cox proportional hazard models were used to examine the relationships between survival rates and factors including status as a widower or widow, chronic disease, and physical function disability. Results: After controlling for potentially confounding variables, survival analysis indicated a relatively higher mortality risk among the widowed compared with those whose spouses were still alive. Of these, widowers showed a higher mortality risk than widows. In addition, incidence of tumor and stroke significantly influenced mortality among both married men and women. Bronchitis, pneumonia, and other respiratory disease significantly raised the risk of mortality for married men but not for married women. Moreover, physical function variables were significant predictive factors related to mortality hazard, with instrumental activities of daily living showing the strongest predictive relationship. Conclusions/Implications for Practice: The study confirmed that widowhood, chronic disease, and physical function were strongly associated with mortality hazard in older people. Therefore, greater attention should be paid to these factors to reduce elderly mortality risk. Research results should be useful in developing welfare strategies for this group.