高齡者鄰里環境宜走性與靜態行為之關聯性研究

「靜態行為」已成為影響高齡者健康的危害因子，而鄰里環境宜走性被認為是導致高齡者靜態行為的因素之一，對於臺灣高齡者靜態行為現況、鄰里環境與靜態行為之關聯性探討有其必要性。本研究擬定之研究目的為 (1) 調查臺灣高齡者靜態行為之現況、 (2) 瞭解臺灣高齡者社會人口學變項與靜態行為之關聯性、 (3) 瞭解臺灣高齡者鄰里環境宜走性與靜態行為之關聯性。本研究針對臺灣65歲以上高齡者利用分層隨機抽樣進行電話訪問調查，主要變項包含社會人口學變項 (性別、年齡、婚姻狀態、教育程度、都市化程度、居住地區) 、靜態行為時間測量 (國際身體活動量調查短版問卷IPAQ-SV) 、客觀鄰里環境宜走性評估 (Walk Score®網站) ，回收有效樣本為1,056位高齡者，資料使用IBM SPSS 23.0進行分析，統計方法包括描述性統計、卡方檢定、二元邏輯斯迴歸分析。研究結果發現臺灣高齡者每日靜態行為時間為272.2分鐘，以年齡75歲 (含) 以上、已婚男性、高教育程度、居住於六都與東部及外島地區者有較多的靜態行為時間，分別使用卡方檢定與二元邏輯斯迴歸分析顯示臺灣高齡者社會人口學變項 (性別、年齡、婚姻、教育程度、都市化程度、居住地區) 與靜態行為皆無統計上的相關性，將研究樣本進一步區分為年齡65至74歲及75歲 (含) 以上兩組，採用二元邏輯斯迴歸分析發現臺灣居住於「非常適合步行」地區65至74歲的高齡者較不容易每日靜態行為時間大於7小時；而居住於「非常適合步行」及「部分適合步行」地區75歲 (含) 以上的高齡者較容易每日靜態行為時間大於7小時。因此，環境的便利性為65至74歲的族群為減少靜態行為的影響因子；在75歲 (含) 以上的高齡者因環境便利性而更容易有較長的靜態行為時間。本研究之結果可提供公部門規劃及減少高齡者靜態行為相關政策之參考，以達高齡者健康促進之目的。建議未來研究可進一步探討高齡者靜態行為類型，並且關注鄰里環境宜走性居住於「非常適合步行」地區的75歲 (含) 以上高齡者靜態行為問題。

關鍵字

Walk Score® ；高齡者；鄰里環境宜走性；靜態行為

並列摘要

“Sedentary behavior” has become a hazard factor that affects older adults’ health. Studies indicate that neighborhood walkability is one of key factors associated with sedentary behavior in older adult population. Therefore, it is necessary to the relationship between neighborhood walkability and sedentary behavior among older Taiwanese adults. This study aimed to investigate (1) time spent of sedentary behavior, (2) relationship between socio-demographic factors and sedentary behavior, and (3) association between neighborhood walkability and sedentary behavior in the population of older Taiwanese adults. A cross-sectional using telephone interview targeting Taiwanese older adults was employed in this research. The main variables include socio-demographic variables (such as gender, age, marital status, education level, degree of urbanization, and residential area), time spent in sedentary behavior (International Physical Activity Questionnaire – short version), and Walk Score®-assessed neighborhood walkability. A total of 1,056 participants were included. Descriptive statistics, Chi-square test, and adjusted binary logistic regression were performed using IBM SPSS 23.0. Our results indicated that average time spent in sedentary behavior in our sample was 272.2 minutes daily. Moreover, older adults who were aged 75 years old and above, married, well-educated, living in Eastern Taiwan (including outer islands) engaged in higher sedentary time. Chi-square test and binary logistic regression analysis showed that there was no statistical associations between socio-demographic variables and sedentary behavior of the older adults in Taiwan. By stratifying our sample into age groups, binary logistic regression analysis showed that older adults aged 65 to 74 years living in “very walkable” area were less likely to engage in sedentary behavior more than 7 hours daily. However, older adults over 75 years old living in “very walkable” and “somewhat walkable” areas were more likely to have prolonged sedentary time (more than 7 hours/ day). The results of this research provided the evidence informing urban planning and policy-makers to reduce older adults’ sedentary behavior. It also suggests that future studies are needed to explore types of sedentary behavior of older adults, and pay attention to the sedentary behavior issues of older adults aged over 75 years old living in “very walkable” areas.