目標:瞭解我國老年症候群之盛行狀況與其相關因素。 方法:本研究採用次級資料分析,利用行政院衛生署國民健康局之民國92年台灣地區中老年身心社會生活狀況長期追蹤第五次調查,並選取65歲以上且完整自答SPMSQ的老人為研究對象共2540位。分析老人老年症候群(包括聽力障礙、視力障礙、跌倒、失禁、眩暈、低身體質量指數、認知功能障礙)之盛行狀況與其相關因素。分析方法以卡方檢定進行相關性檢定,再以二元邏輯斯迴歸與多元邏輯斯迴歸分析進行整體模式之檢驗。 結果:分析樣本中老年症候群之盛行率為48.6%,平均每位老人有0.8項老年症候群。其中,最常見的老年症候為視力障礙(19.3%)、跌倒(15.7%)、失禁(14.2%)。邏輯斯迴歸分析結果顯示女性、年齡越大、自覺健康不好、罹患慢性病數越多、身體功能障礙與有憂鬱傾向者,出現各老年症候的機會顯著越高;而多元迴歸分析中發現,比較三項以上老年症候群及沒有任何老年症候群之兩組樣本發現,女性(OR=1.74,95%CI=1.11-2.27)、80歲以上老人(OR=4.03,95%CI=2.06-6.83)、居住在鄉下(OR=1.57,95%CI=1.07-2.31)、沒有工作(OR=1.98,95%CI=1.34-2.92)、自覺健康不好(OR=5.38,95%CI=3.09-9.39)、罹患三種以上慢性疾病(OR=4.47,95%CI=2.74-7.30)、身體功能有障礙(OR=2.90,95%CI=1.81-4.67)、有憂鬱傾向(OR=3.35,95%CI=2.22-5.05)、不瞭解疾病飲食控制知識(OR=1.69,95%CI=1.09-2.62)和對疾病預防知識不瞭解(OR=1.78,95%CI=1.10-2.78)者,出現三項以上老年症候群機會較高;若比較有兩項老年症候群與沒有任何老年症候群兩組樣本則發現,平常有社交活動(OR=1.38,95%CI=1.05-1.67)者,發生兩項老年症候群的機會則顯著較高。 結論:性別、年齡、居住地、工作情形、自覺健康情形、罹患慢性病、憂鬱傾向、身體功能、社交活動情形、對疾病飲食控制知識的瞭解程度與對疾病預防知識的認知情形,均為老年症候群發生的重要相關因素。未來建議相關政策應對於易發生老年症候群之高危險族群加以關注,經由適當的政策與衛生教育的介入,以延緩及預防老年症候群的發生,進而減少老人健康惡化與失能,降低醫療利用,並促使老人成功老化。
Object:To examine the prevalence of geriatric conditions and the associated factors. Method:This study based on the secondary data from “Survey of the Health and Living Status of the Middle-Aged and the Elderly in Taiwan” collected by Bureau of Health Promotion, Department of Health in 2003. Twenty five hundred and forty subjects who were over 65 years old and reported SPMSQ by themselves were recruited. Geriatric conditions included hearing impairment, vision impairment, falls, incontinence, dizziness, low body mass index and cognitive impairment, and we used binary logistic regression and multinomial logistic regression to find out the associated factors with geriatric conditions. Results:There were 48.6% of sample had at least one geriatric condition among Taiwanese elderly. Hearing impairment (19.3%), falls (15.7%) and incontinence (14.2%) were the most common geriatric conditions. Binary logistic regression showed that, female, older, poor self-rated health, had more chronic diseases, had limitations in physical function, and depressive tendency were more likely to have geriatric conditions. Multinomial logistic regression showed that, compared with those who had no geriatric conditions, those who tend to have three geriatric conditions and above were femal (OR=1.74, 95%CI=1.11-2.27), older than 80 years old (OR=4.03, 95%CI=2.06-6.83), lived in the country (OR=1.57, 95%CI=1.07-2.31), without work (OR=1.98, 95%CI=1.34-2.92) , poor self-rated health (OR=5.38, 95%CI=3.09-9.39), had more chronic diseases (OR=4.47, 95%CI=2.74-7.30), depression (OR=3.35, 95%CI=2.22-5.05), limitations in physical function (OR=2.90, 95%CI=1.81-4.67), without diet knowledge about disease control (OR=1.69, 95%CI=1.09-2.62) and without knowledge about disease prevention (OR=1.78, 95%CI=1.10-2.78). Elders who were had social activities (OR=1.38, 95%CI=1.05-1.80) had higher probability to get more geriatric conditions. Conclusions:Gender, age, living area, work status, self-rated health, chronic diseases, depressive tendency, physical function, social activities, diet knowledge about disease control and care knowledge about disease prevention were the important factors associated with geriatric conditions. Geriatric conditions could be prevented by health educations and appropriate health policies. The policy maker should pay more attention about the elders who had higher risk of geriatric conditions to reduce disability rate and medicine utilizations in the future.
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