台灣地區老年人跌倒趨勢暨相關因素之回溯性世代研究

目的：台灣老人跌倒之相關研究中，較少研究提及老人跌倒的趨勢變化，以及相關因素的變化是否會對老人跌倒趨勢的變化造成影響。本研究以回溯性世代研究的方式，探討台灣地區老人跌倒的變化趨勢，並瞭解其相關因素變化情形所造成的影響。研究方法：本研究利用國民健康局外釋資料檔案「中老年身心社會生活狀況調查研究」，針對三個年度(民國88年、民國92年、民國96年)的資料庫進行資料分析。總計使用4808位樣本來探討老人跌倒的變化趨勢與相關因素變化情形的關聯性。研究結果：由研究結果顯示觀察時間越長，老人跌倒與相關因素變差的比例越高。會造成跌倒狀況變差的因素包括：年齡較大、女性、教育程度較低、配偶狀態有改變、自認健康狀態變差、大小便失禁狀況變差、ADL與IADL依賴程度變高、慢性病數量增加、藥物使用種類增加、喝酒習慣變差、使用輔具幫助行走的狀況增加、生活滿意度變差、壓力與抑鬱狀況變差休閒活動數目增加、對居住房子感覺變差。結論與建議：定期監測老人跌倒之狀況與相關因素變化情形，即時提供適當的健康照護活動。除了老人的生理健康外，亦應注重心理健康及社交網絡的健全，因此在預防老人跌倒時，應從全方位考量，設計一個適合老人生活的居住環境。

關鍵字

老人跌倒；回溯性世代研究；危險因素

並列摘要

Object： Among the studies of elderly falls in Taiwan, the changes of falling trends and related factors are rarely mentioned. In this study, we use retrospective cohort study to discuss the changes of falling trends and the impact of changes on related factors in Taiwan. Methods： The study sample is come from the ‘Physiological, Social and Living Status Survey of Middle-Aged and Elderly’ of the Bureau of Health Promotion. We use 1999, 2003, and 2007 three different periods and 4808 samples to analysis the changes of falling trends on elderly, and to find out the impact of the changes of related factors. Result： The longer observation time, the percentage of the relative factor of elder falling worse is higher. The risk factors of worsen situation on falling are older, female, lower education, change of spouse status, bad self-perceived health status, incontinence, worse ADL and IADL, increase of number of chronic disease, multiple use of drugs, increase of frequency of drinking, using of assistive device, lower satisfaction of life, increase of pressure, more depress, decrease of leisure activities, dissatisfaction of the living environment. Conclusion and Recommend： We should regular monitor the elder falling and the change of relative factor to provide the appropriate health care activity. Besides the physical health, the metal health and social support are important to elders. In order to prevent the falls among the elderly, we should use comprehensive thought, and developing a well-living environment.