台灣地區老年人自覺視力惡化之預測因子探討—三年縱貫性研究分析

Predictive Factors of Self Perceived Vision Impairment in the Elderly in Taiwan : a Three-Year Longitudinal Study

劉智誠(Jyh-Cheng Liou)

指導教授 ： 李孟智

中山醫學大學/醫學院/醫學研究所/碩士(2014年)

https://doi.org/10.6834/CSMU.2014.00175

摘要

研究目的：探討台灣老年族群自覺視力惡化的預測因子。
研究方法及資料：本研究使用國民健康局由1989年開始的「台灣中老年人身心社會狀況長期追蹤調查」資料庫，以1996年65歲以上2159位自覺視力良好老人為研究對象進行世代追蹤研究。於1999年扣除死亡230人及遺失樣本113人，有1816人完成訪問進入分析。視力不良定義為訪問中表示自覺視力不清楚。自變項由訪問收集性別、年齡、教育程度、種族、經濟狀況、罹患慢性疾病、憂鬱程度、健康行為、健康飲食及使用營養補充品之狀況。先以卡方檢定進行單變相分析，再將有顯著差異的變項進入邏輯斯回歸分析。
研究結果：從1996到1999年，共有294位老人視力惡化，發生率16%。經邏輯斯迴歸分析，低教育程度(小學vs不識字OR=0.5, CI=0.34-0.72; 中學vs不識字OR=0.19, CI=0.10-0.38; 大專vs 不識字OR=0.15, CI=0.04-0.54)、原住民籍貫(OR=5.5, CI=1.92 -15.56) 、中風(OR=2.21, CI=1.03 -4.73)、白內障(OR=1.53, CI=1.05 -2.22) 、憂鬱(OR=1.57, CI=1.10 -2.20)會增加老人視力惡化之風險。
結論與建議：低教育程度、原住民籍貫、中風、白內障、憂鬱是老人視力惡化之預測因子，有較高視力惡化高風險的老人，應接受評估並積極治療，以避免視力日益惡化。

關鍵字

老人 ； 視力不良 ； 危險因子 ； 縱貫性研究

並列摘要

Purpose：Just few epidemiology data of longitudinal study has been available on risk factors of visual impairment in Taiwanese elderly. The purpose of the study was to determine the predictive risk factor associated with visual impairment in a nationwide elderly population in Taiwan.
Methods and Materials：Data were obtained from the “Survey of Health and Living Status of the Elderly in Taiwan”, which was launched in 1989. We used data in 1996 as the baseline to conduct a cohort of 2159 persons aged 65 to 103 years participated in the interview. There are 1816 persons participated in follow-up interviews in 1999. Visual impairment was defined by self-perceived difficulty in seeing. Independent variables, including sex, age, education, ethnicity, income, chronic diseases, depression status(evaluated by CES-D) , health behaviors, food and nutrition supplement were gathered at baseline. A Chi-square test was used for univariate analysis. Statistically significant (p<0.05) univariate relationships were entered into logistics regression model.
Results：In the three years follow-up, the incidence of visual impairment was 16%(n=294). Risk factors of low education level (elementary vs illiterate OR= OR=0.5, CI=0.34-0.72; medium vs illiterate OR=0.19, CI=0.10-0.38; high vs illiterate OR=0.15, CI=0.04-0.54), aborigines (OR=5.5, CI=1.92 -15.56), stroke (OR=2.21, CI=1.03 -4.73), cataract (OR=1.53, CI=1.05 -2.22), depression (OR=1.57, CI=1.10 -2.20)were independent predictive factors for visual impairment.
Conclusion and Suggestion：Those who are at high risk of visual impairment should receive detail assessment and active management to prevent visual disability.

並列關鍵字

the elderly ； visual impairment ； risk factor ； longitudinal study

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