台灣老年人身體功能之軌跡分析

The trajectory of physical function among elderly in Taiwan

趙育晟(Yu-Cheng Chao)

指導教授 ： 葉志嶸

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2011年)

https://doi.org/10.6834/CSMU.2011.00081

摘要

研究目的：隨著國人平均餘命增加，老年人失能盛行率急遽上升，探討失能前期身體活動功能指標就顯得相形重要。本研究探討性別、年齡、教育程度、婚姻狀況、運動情形、飲酒情形、吸菸情形、疾病狀況、自覺健康狀態、憂鬱狀況與身體活動功能軌跡之相關性。並以不同的身體活動功能軌跡探討與晚期失能指標IADL、ADL之相關。
材料方法：1996年至2007年國民健康局「台灣中老年身心社會狀況長期追蹤調查」的資料，以1996、1999、2003、2007年4波資料進行軌跡分析探討。
結果：身體活動功能各軌跡比較，「維持良好」相較於「維持不佳，緩慢上升」、「維持不佳，快速上升」兩組。在性別、年齡、疾病狀況、自覺健康狀態、憂鬱狀況皆會增加身體活動功能受損風險(OR=1.9、OR=1.04、OR=3.74、OR=1.69、OR=1.6，前者)；(OR=3.38、OR=1.07、OR=8.23、OR=1.72、OR=1.89，後者)；教育程度在各組均則具保護作用。而在IADL部分，各組身體活動功能軌跡與IADL都呈現正相關；在ADL部分，「維持不佳，快速上升」、「控制不佳，緩慢上升」軌跡與IADL呈現正相關。
結論：性別、年齡、疾病狀況、自覺健康狀態、憂鬱狀況，會增加身體活動功能受損的風險，尤其於身體活動功能快速惡化的組別其影響性更為劇烈；身體活動功能軌跡對於晚期的IADL指標有較好的預測能力。

關鍵字

身體活動功能 ； 工具性日常生活量表 ； 日常生活量表 ； 軌跡分析

並列摘要

Objectives：As life expectancy lengthens and prevalence of disability increases in elderly, it is important to understand the early stage of disability, mobility limitations. This longitudinal study aims at the relation between mobility trajectory and the potential risk factors including gender, age, education level, marital status, exercise, drinking, smoking, disease status, self-rated health, and depression status. The association between mobility trajectory and Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) is investigated.
Methods：Four-wave longitudinal data from “The Survey of Health and Living Status of the Near Elderly and Elderly in Taiwan” in 1996, 1999, 2003, and 2007 were included for trajectory analysis.
Result: In comparison with the “good maintenance” group, both the “poor maintenance, slow impairment” and the “poor maintenance, fast impairment” groups were related to the potential risk factors including gender, age, disease status, self-rated health, and depression status (OR=1.9, 1.04, 3.74, 1.69, and 1.6 for the former group, and OR=3.38, 1.07, 8.23, 1.72, and 1.89 for the later, respectively). Education level was a protective factor to mobility limitations. In addition, mobility trajectory of each group was positively correlated with IADL. Nevertheless, only two groups, the “poor maintenance, slow impairment” and “poor maintenance, rapid impairment” were positively correlated with ADL.
Conclusion: Gender, age, disease status, self-rated health, depression status increased the risk of mobility limitations, especially in the “poor maintenance, rapid increase” group. Mobility trajectory appeared to have better association with future IADL.

並列關鍵字

mobility ； IADL ； ADL ； trajectory analysis

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