衰弱症多面向老化功能風險自動化檢測之臨床應用

The Clinical Application of Automatic Assessment of Frailty and Age-associated Multiple Functional Risks

李昕怡(Hsin-Yi Li) ； 毛慧芬(Hui-Fen Mao) ； 劉文俊(Wen-Jing Liu) ； 陳晶瑩(Chin-Ying Chen) ； 陳慶餘(Ching-Yu Chen)

《台灣老年醫學暨老年學會雜誌》 16卷1期 (2021/02) Pp. 72-85

https://doi.org/10.29461/TGGa.202102_16(1).0006

摘要

本報告首先以2019年Lancet期刊所發表二篇老年衰弱症最新進展為藍本，檢視並比較台灣與最近衰弱症文獻搜尋所發表的進展與改善策略，結果顯示台灣有關老年衰弱症的臨床和公共衛生及政策的實踐，皆能迎合國際潮流。在此基礎之下，進一步介紹老年衰弱症多面向功能風險的自動化檢測，佐以急性病衰弱症老人個案於住院及出院後追蹤檢測結果及後續功能改善狀況，印證老年衰弱症在急性病恢復後，仍存在動態性變化的多面向功能風險，提醒老年照護團隊需要規劃持續性多面向的介入性改善措施，發展具經濟效益及實證基礎的生活型態及臨床老化功能改善方案，以恢復衰弱症老人之健康。最後，台灣本土發展之多面向老化功能風險自動化檢測可以更全面且有效率地篩檢不同類型的衰弱症個案，在慢性疾病、各面向功能表現、活動參與、社教和安寧療護等層面的實務應用提出建議，以期達到預防及延緩失能、活躍老化的目標。

關鍵字

老人 ； 衰弱症 ； 功能風險 ； 自動化檢測

並列摘要

In 2019, the Lancet published a two-paper series about the implications and management of frailty. Taking the series as references, this article reviewed the recent literature of frailty management strategies and compared the results to the of management strategies and policies developed in Taiwan. Our findings indicated that the clinical practice and public health policies of frailty in Taiwan had been updated to keep pace with international progress. In addition to the findings, we conducted a case report to introduce a new automatic assessment of frailty and age-associated multiple functional risks. We presented the case of a frail older adult with an acute illness to demonstrate that, even though the discharged frail patient recovered from the acute illness, a 6-month follow-up revealed that this frail older adult might still present multiple functional risks in spite of the improvement in his dynamic condition of frailty. This reminded the members of the interdisciplinary geriatric team of the need to draft a sustainable care plan with multi-domain intervention strategies and develop a cost-effective lifestyle-based program for any frail older adults with acute illnesses. Finally, the developed automatic assessment of frailty and age-associated multiple functional risks in Taiwan may be a more comprehensive and efficient choice for detecting function-related risks. According to the results of the assessment, we offered several suggestions for taking care of older adults on the domains of chronic diseases, functional performance, activity and participation, socio-cultural educational characteristics, and palliative care in clinical practice in order to manage personal health and make professional intervention plan for each individual.

並列關鍵字

elderly ； frailty ； functional risk ； automatic assessment