高齡者靜態行為型態與老年憂鬱症狀之關聯性研究

Abstract

研究目的：老年憂鬱症狀是老年症候群中最常見的疾病症狀，它可能與許多行為因素有關，而靜態行為可能是其中一項行為因素，但目前尚不清楚靜態行為與老年憂鬱症狀間的關聯。此外，鮮少研究關注整體靜態行為型態（總靜態行為時間、靜態行為回合及靜態行為中斷）與老年憂鬱症狀之關係。故本研究旨在調查高齡者的靜態行為型態與老年憂鬱症狀之關聯性。研究方法：本研究為橫斷性研究設計，於2020 年 9 月至 2021 年 9 月於某醫學中心門診部進行資料蒐集。參與者年齡皆為65 歲 (含) 以上，能獨立行走，且無認知功能風險的社區高齡者。本研究使用三軸加速度計連續 7 天蒐集靜態行為型態之數據，老年憂鬱症狀則是透過 15 項老年憂鬱量表 (15-item Geriatric Depression Scale, GDS-15) 進行量測。本研究運用二元邏吉斯迴歸模型檢驗「總靜態行為時間」與GDS-15 分數之間的關聯；再利用多元線性迴歸模型檢驗「靜態行為回合次數 (30分鐘/回合)」、「中斷靜態行為的頻率」和GDS-15分數之關係。研究結果：本研究共計167名臺灣高齡者納入分析 (平均年齡：80.2±7.0 歲；50.9%為男性；15.6% 有老年憂鬱症狀風險)。在調整潛在干擾因子後，每日總靜態行為時間高於9小時的高齡者與老年憂鬱症狀並無存在顯著性相關，靜態行為回合次數 (30分鐘/回合) 和中斷靜態行為的頻率與老年憂鬱症狀均無任何顯著性相關。研究結論：本研究發現，對本研究樣本而言，整體靜態行為型態 (總靜態行為時間、靜態行為回合次數 (30分鐘/回合) 及中斷靜態行為的頻率)與老年憂鬱症狀並無存在顯著性相關。建議未來研究可同步使用客觀測量儀器與自陳式靜態行為問卷進行評估，如此才能明確得知客觀數據及主觀資料的心智功能主動或被動形式之靜態行為 (如看書、看電視)，進而更能完整釐清靜態行為型態對於老年憂鬱症狀之關聯性。

Objectives: Geriatric depressive symptoms (GDS) are the most common symptom in geriatric syndromes, and it could link to several behavioral factors. Sedentary behavior (SB) is a potential behavioral risk factor related to GDS, but the relationship SB and GDS remains unclear. Moreover, few studies using objective measurement examined the relationship between comprehensive SB pattern (total SB time, sedentary bouts, and sedentary breaks) and the risks of GDS. Therefore, this study aimed to investigate the association between SB pattern and GDS in older adults.Methods: A cross-sectional study was implemented in an outpatient department from September 2020 to September 2021. Participants were community-dwelling older adults who aged 65 years and older, were able to walk independently, and no at risk of cognitive function. SB pattern was measured using a tri-axial accelerometer for 7 consecutive days, and GDS was measured via 15-Item Geriatric Depression Scale (GDS-15). A binary logistic regression model was used to examine the association between total SB time and GDS-15 scores; multiple linear regression models were performed to estimate the relationship of sedentary bouts (30 mins / bout) and sedentary breaks (any breaks) with GDS-15 scores.Results: A totalof 167 older Taiwanese adults (mean age: 80.2±7.0 years; 50.9% male; 15.6% at risk of GDS) were included. After adjusting for potential confounders, achieving SB time>9h/day was not significantly associated with the risk of GDS; greater times of sedentary bouts and more sedentary breaks were not also associated with GDS in our sample. Conclusion: This study showed that the SB pattern (total SB time, sedentary bouts [30 mins/bout] and sedentary breaks [any breaks]) was not associated with the risk of GDS among older adults in the sample of this study. It is suggested that further research can simultaneously use objective measurement instruments and self-reported questionnaires for evaluation, so that objective data and subjective material (mentally-active SB [such as reading a book] or passive SB [such as watching TV]) can further complete clarify the association between SB patterns and GDS in the older adults.