- 學位論文
台灣中部及東部地區中老年人手握力變化之研究
Handgrip Strength Change with Aging Taiwanese Middle Aged and Older Adults in Central and Eastern Regions of Taiwan
摘要
研究目的：已知性別為影響手握力的重要原因，故本研究皆以性別做為分組進行探討，研究目的為（1）報告每5歲間手握力的下降速率及衰退量，（2）探索手握力驟降的年齡，及（3）探討不同慢性疾病對於手握力衰退之影響。 研究方法：自願參加本研究之社區中老年人，先由研究人員說明研究目的及測試的過程，並簽署人體試驗委員會核准的同意書後進行測試。上肢接受過手術、上肢功能異常或身體任何部位有疼痛會影響手握力測試者，皆排除於本研究。首先，經由訪談方式獲得人口學資料，測量身高（公尺）及體重（公斤），再以Jamar手握力器於標準姿勢下進行慣用手的握力測量。計算出每年齡層與前一年齡層的手握力絕對差及百分比(%)。組間手握力平均值的差異以變異數統計（ANOVA）分析，使用彎曲線性回歸分析（Bent linear regression）並調整年齡、身高、體重，找出男女手握力快速下降的臨界年齡。以多變項線性迴歸分析（Multiple linear regression）比較不同慢性疾病對於手握力之影響。 研究結果：共有353位男性（45-98歲，平均74.1±7.5歲）及441位女性（48-97歲，平均73.6±5.8歲）加入本研究。研究結果發現，在不同年齡層之間衰退速率不同，男性與女性皆於85歲以上衰退百分比最大，且分別在71歲及69歲為手握力快速下降之臨界年齡。慢性疾病中，糖尿病為影響女性手握力之顯著因子，且女性糖尿病患者的手握力快速下降臨界年齡為60歲。 結論：過去也有許多學者探討中老年人之手握力衰退情形，本研究結果與其他研究不盡相同。手握力測試為臨床常使用之評估方式，瞭解國內中老年人之衰退情形及速率有利於及時介入及預防失能。
並列摘要
Objective: It is well established that gender is an important factor of changes in handgrip strength; therefore, the subjects enrolled in this study were initially divided according to their gender before further examination was conducted. The purpose of this study was (1) to report the decline rate of handgrip strength, (2) to explore the boundary age when the grip strength would decline rapidly and (3) to explore the impact of different chronic diseases on recession grip strength among community-dwelling, middle to old aged Taiwanese adults. Methods: These community elderly who volunteered to participate in this study were thoroughly explained the purpose and process of testing by the researchers at first and subsequently signed IRB informed consent. Participants who had received any surgical treatment on upper limb or experiencing upper limb dysfunction or pain at any part of the body that would affect handgrip strength test were excluded from this study. All demographic data were obtained through interviews, measurements of body height (m) and body weight (kg) by researchers, and handgrip strength was measured three times in dominant hand by using Jamar Hand Dynamometer in a standard posture. This study calculated the absolute difference and percentage (%) of handgrip strength between each age level. Group differences were compared by using a one-way analysis of variance. Additionally, Bent linear regression (adjusted for age, height, and weight) was used to identify a critical age of rapid decline in handgrip strength of men and women. Results: There were 353 men (45-98 years, mean 74.1±7.5 years) and 441 women (48-97 years, mean 73.6±5.8 years) in this study. The results of Bent regression analysis revealed that the boundary age of rapid handgrip strength decline was 71 and 69 years for men and women, respectively. Diabetes is a significant factor for handgrip strength decline in women and the boundary age of rapid handgrip strength decline was 60 years for women with diabetes. Conclusion: There have been many studies on handgrip strength decline in middle aged and older adults. However, the results of these studies are not all the same. Handgrip strength test is an assessment tool commonly used in clinical setting, and fully understanding the situation of handgrip strength decline in the elderly population will certainly bring timely intervention and prevention of disability.