以跨理論模式探討臺灣高齡者從事肌力活動行為與慢性疾病風險之研究

目的：肌力活動行為是高齡者維持日常活動及預防失能的重要因子，亦能夠帶來許多健康益處，如增加肌力、減少骨質流失等。然而國內探討肌力活動行為與疾病關係及關聯因素之相關文獻卻付之闕如，因此本研究欲以跨理論模式為基礎，旨在瞭解臺灣高齡者從事肌力活動行為之現況，以及其與慢性疾病風險之關聯性。方法：本研究採用橫斷式調查法，以電腦輔助電話訪問的方式，蒐集臺灣高齡者從事肌力活動行為之行為改變階段、慢性疾病狀況，以及社會人口學變項，共取得1,064份有效樣本，並以二元邏輯斯迴歸進行分析。結果：一、高齡者從事肌力活動行為之行為改變階段，有24.0%的人處在維持期，有18.0%的人是處在意圖期-行動期，而有58.1%的人處在無意圖期，即近半數之高齡者從未考慮從事肌力活動行為；二、在社會人口學變項與肌力活動之關聯性方面發現，年齡超過85歲以上、教育程度為高中職以下者，較不容易從事肌力活動行為；三、處在無意圖期的高齡者，相較處在維持期者，增加1.52倍的機率有高血壓及1.50倍的機率有第二型糖尿病的風險。結論：本研究發現高齡者從事肌力活動行為與高血壓及糖尿病之風險有關。然而目前臺灣高齡者人口仍有58.1%的人未考慮從事肌力活動行為，建議未來政策執行者在擬訂預防慢性病及相關政策時，能夠將肌力活動行為納入考量，運用跨理論模式中的改變過程，來為處在不同行為階段的對象設計適合的策略，並且優先針對年齡超過85歲、教育程度為高中職以下者進行介入，以利提升從事肌力活動行為之人口，進而達到活躍老化之願景。

關鍵字

高齡者；肌力活動；高血壓；糖尿病；行為改變階段

並列摘要

Background: Strength training behavior has been considered as a key factor for older adults to maintain daily activity and prevent disability. However, there is little evidence between strength training behavior and the risk of chronic disease. Thus, this study used the Transtheoretical model to examine the associations between strength training behavior and the risk of chronic disease in older Taiwan adults. Methods: A telephone-based cross-sectional survey targeting older Taiwanese adults was conducted in 2017. Data related to stages of change for strength training behavior, chronic diseases, and socio-demographic variables were obtained from 1,064 older adults. Adjusted binary logistic regression was then performed. Results: a. 58.1% of the participants were in Pre-contemplation stage, and 24% of them were in Maintenance stage. b. Participants who were 85 years or older, or with lower education levels were less likely to engage in strength training. c. After adjusting for potential confounders, older adults of pre-contemplation stage were more likely to have hypertension (OR=1.52; 95%CI 1.12-2.06) and diabetes (OR=1.50; 95%CI 1.01-2.24) compared with those of maintenance stage. Conclusions: These findings suggest that engagement in strength training behavior was related to the risk of hypertension and diabetes in older adults. However, there were still 58.1% of the elderly people in Taiwan didn’t consider engaging in strength training. Therefore, it is important to promote the suitable strategies on the basis of Transtheoretical model, especially for older adults who were 85 years +, and with lower education levels.