肥胖對老人功能限制的發生之影響

The Effect of Obesity on developing Functional Limitations among the elderly in Taiwan

郭惠珊(Kuo Hui Shan)

指導教授 ： 董和銳

亞洲大學/健康學院/健康管理研究所/碩士(2010年)

摘要

幾十年來，許多研究已經證實，肥胖是許多慢性疾病的一個重要危險因素，而一般最常見於老年人口。然而，較少研究探討過重而影響失能的發生，這是一個更有意義的方法，以反映我們對於體弱老年人口的照護負擔。使用全國具有代表性的老年人樣本，而這些老年人是完全沒有功能限制，因此本研究在探討如果體重超過標準與在四年後發生功能限制間的關係。
　　資料來源取自第四波台灣中老年的健康與生活狀況調查。有4440位54歲及54歲以上的老年人受訪，其中，在1999年裡1817人是完全沒有身體力量功能限制，2302人是完全沒有身體上肢功能限制，和1984人是完全沒有身體下肢功能限制。三個分開來分析，進行3個老年人子樣本的分析。預測隨著身體質量指數（BMI）被依序放入邏輯斯迴歸模型來預測2003年發生功能限制的情形。
　　結果發現，四年期間發生身體力量功能限制為40.95%，而發生身體上肢功能限制與身體下肢功能限制分別為30.10％和36.09％。老年人不論是體重過重或體重過輕的人四年後更容易發生身體功能限的問題。然而，在控制其它變項後，不正常的身體質量指數（BMI）最後是沒有影響的。
　　基於我們的研究結果發現，似乎不正常的身體質量指數（BMI）會增加老年人身體功能限制的發生，但是，這種影響可以被其他控制變項所解釋掉，如年齡、性別、社會經濟地位和其他變項。

關鍵字

肥胖 ； 身體質量指數 ； 老人 ； 功能限制

並列摘要

Over past decades, numerous studies have confirmed that obesity is an important risk factor for many chronic diseases, which are commonly seen among older populations. However, fewer studies have examined the effect of excessive weight on the onset of disability, which is a more relevant measure to reflect the care burden of our frail elderly populations. Using a national representative sample of the elderly in Taiwan, who were free of any functional limitations (FLs) at baseline, this study was to examine if an abnormal body weight is associated with the onset of FLs 4 years later.
　　Data were taken from the fourth wave of the Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan. There were 4440 cases aged 54 and over were interviewed and, among them, 1817 cases were free in their strength FLs, 2302 cases were free of upper-body FLs, and 1984 cases were free of lower-body FLs in 1999. Three separate analyses were conducted for each of the 3 sub-samples of elders. A set of predictors, along with Body Mass Index (BMI) were entered hierarchically into in logistic regression models in predicting the onset of FLs in 2003.
　　Results showed that the incidence rate of developing a strength FLs over the 4 year-period was 40.95% and the incidence rates for developing an upper-body and lower-body FLs were 30.10% and 36.09%, respectively. Elders with either an overweight or underweight BMI were more likely to develop a FL 4 years later. However, the significance of an abnormal BMI disappeared after other covariates were controlled for.
　　Based on our findings, it seems that an abnormal BMI does increase the elders’ risk of developing FLs, however, this effect can be explained away by other controlled variables, such as age, gender, socioeconomic status, and other types of FLs.

並列關鍵字

obesity ； body mass index(BMI) ； elderly ； functional limitation

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