社區高齡者預防跌倒、憂鬱與提升認知能力之健康促進計畫－一個10週社區據點活動成效探討

隨著邁入高齡化社會，老化隨之而來的生活困擾越來越受到重視，尤其社區老人常遭遇跌倒、憂鬱情緒和認知障礙所產生的失能狀況經常造成嚴重的生活困擾，故本研究透過篩檢來強調預防醫學的概念，提供危險族群儘早獲得相關的醫療服務，以及目標導向的身體活動和多元刺激的認知活動，來倡導老人心智健康及預防憂鬱及跌倒的重要性。我們提供10週的社區據點健康促進活動給40位高齡者，運用認知搭配體能活動來預防跌倒降低憂鬱及提升認知功能，使用「Timed up and go test」（簡稱TUG）、簡式老年人精神憂鬱量表（Geriatric Depression Scale，簡稱GDS）、簡易智能狀態測驗（Mini-Mental Status Examination, 簡稱MMSE）等評量來進行前後測試，結果發現:老人在跌倒風險、憂鬱傾向和認知能力方面有顯著改善，認知能力較高則跌倒風險越小，且憂鬱情緒增加則跌倒風險上升，再者推測認知能力和憂鬱傾向可成為跌倒風險的預測因子。因此建議臨床及教育訓練上可透過認知促進及降低憂鬱情緒活動來避免跌倒所產生的生活功能依賴，並提升生活品質，達到身心健康之活躍老化。

關鍵字

高齡者；認知；跌倒；憂鬱；社區據點；活躍老化

並列摘要

With the stepping into an aging society, more and more attention has been paid to the life problems that accompany aging. In particular, the elderly in the community often suffer from falls, depression, and cognitive impairment, which often cause severe life problems. Therefore, this study through screening, we emphasize the concept of preventive medicine, provide risky groups with early access to relevant medical services, and target-oriented physical activity and multiple stimulating cognitive activities to advocate the importance of mental health of the elderly and the prevention of depression and falls. We provide 10 weeks of community-based health promotion activities to 40 elderly people, using cognition and physical activities to prevent falls, reduce depression and improve cognitive function, use ＂Timed up and go test＂ (TUG), simple mental depression of the elderly Geriatric Depression Scale (GDS), Mini-Mental Status Examination (MMSE) and other assessments were conducted before and after tests, and the results showed that the elderly had significant improvements in fall risk, depression tendency and cognitive ability , The higher the cognitive ability, the lower the risk of falling, and the increase in depression will increase the risk of falling. Furthermore, it is speculated that cognitive ability and depression tendency can be predictors of the risk of falling. Therefore, it is recommended that clinical and educational training can use cognitive promotion and depression reduction activities to avoid the life function dependence caused by falls, and improve the quality of life to achieve active aging of physical and mental health.

並列關鍵字

Elderly ； Cognition ； Falling ； Depression ； Community Center ； Active Aging

參考文獻

Bárrios, H., Narciso, S., Guerreiro, M., Maroco, J., Logsdon, R. and de Mendonça, (2013). Quality of life in patients with mild cognitive impairment. Aging and Mental Health, 17(3), 287-292. doi: 10.1080/13607863.2012.747083.

Lee, P. L., Chang, H. H., Huang, C. K., Cheng. W. C., Lee. P. Y. and Chao. H.C. (2018). Memory training program for older adults, Educational Gerontology, 44(10), 614-626.DOI:10.1080/03601277.2018.1511099.

國家發展委員會 (2020). 高齡化時程，取自 https://www.ndc.gov.tw/Content_List. aspx?n=695E69E28C6AC7F3.