高齡者衰弱程度與其客觀測量靜態行為之探討

Abstract

背景：人口老化已成為全球社會及衛生政策重要議題。隨著醫療環境及照護的進步與改變，國人的平均餘命亦逐年增長。衰弱（frailty）除了是全球關注的議題外，也是目前老年人常見的問題，而靜態行為 （Sedentary Behavior）近年來已成了新興威脅健康的因子之一且已逐漸被視為重要的公共衛生議題，而且在老年人的生活中相當普遍。在目前的文獻中發現，衰弱與靜態行為的相關性研究探討大多以自陳式問卷來蒐集資料居多，而國內對於衰弱程度與靜態行為且利用客觀儀器測量的研究鮮少被探討。因此本研究目的：為瞭解高齡者衰弱程度與其靜態行為之現況及探討高齡者衰弱程度與其靜態行為之關聯性。方法：本研究為橫斷性調查，招募臺北市某醫學中心老人健檢與整合門診 65 歲（含）以上之高齡者，有效樣本數共 218 人。使用「臨床衰弱量表」（Clinical Frailty Scale, CFS）進行衰弱症評估，並透過客觀測量儀器「三軸加速規」進行靜態行為模式資料收集。資料採用SPSS 23.0 進行統計分析，統計方法包括卡方檢定、單因子變異數分析及簡單線性迴歸分析。結果：發現（1）年齡、主要照顧者及服用多種藥物這三部分在社會人口學、衰弱程度及靜態行為：包括總靜態時間（分鐘/天）及持續 ≧ 30分鐘靜態行為（次/天）中均有顯著差異。（2）線性回歸結果顯示，「衰弱程度越高」與「總靜態時間」及「持續 ≧ 30分鐘靜態行為的次數」，均呈現正相關。結論：建議政府機關在高齡者健康促進政策中，應積極宣導衰弱及靜態行為對銀髮族造成的影響，衰弱與靜態行為均是高齡者不容忽視的健康議題，如果能夠早期偵測衰弱症及減少靜態行為，藉由飲食、運動以及生活方式的改變，應能及早預防失能，減少年老時臥床的時間。期待未來高齡者不只要活得長壽，更要活得健康有品質，讓臺灣邁向更成功的健康老化趨勢。Background: Population aging has become an important issue in global social and health policies. With the progress and changes in the medical environment and care, the average life expectancy of Taiwanese people has also increased year by year. Frailty is not only a global concern but also a common problem among the older adults. Sedentary behavior has become one of the emerging threats to health in recent years and has gradually been regarded as an important public health issue. Moreover, sedentary behavior is quite common behavior in the lives of older adults. Current literature shows that most of the research have examined the correlation between frailty and sedentary behavior using self-reported questionnaires to collect data, while domestic research on the degree of frailty and sedentary behavior using objective instruments is rarely discussed. Therefore, the purpose of this research is to understand the current status of the frailty of older adults and their sedentary behavior, and to explore the association between the frailty status and objectively-measured sedentary behavior in older adults. Methods: This study is a cross-sectional survey, recruiting older adults ages 65 and above in a medical center in Taipei City, with a total of 218 valid samples. The study employed the"Clinical Frailty Scale"（CFS）for frailty assessment, and used the objective measuring instrument "three-axis accelerometer" to collect static behavior pattern data. The data was analyzed by SPSS 23.0, and the statistical methods included chi-square test, single factor variance analysis, and simple linear regression analysis. Results: The findings were:（1）There are significant differences of age, main caregivers and taking multiple drugs with sedentary behavior pattern: including total sedentarytime（minutes/day）and sedentary behaviors lasting ≥ 30 minutes（times/day）.（2）The higher the degree of frailty, the longer the total objective sedentary time and the more sedentary behaviors lasting ≥ 30 minutes（times/day）, all showing a positive correlation. Conclusion: This study informed that government agencies should increase the awareness of the negative impact of frailty and sedentary behaviors for the older adults. Both frailty and sedentary behaviors are important health issues for elderly people. If frailty and sedentary behavior can be detected early and sedentary behaviors reduced through changes in diet, exercise, and lifestyle, it is possible to prevent disability onset and reduce the time spent in bed in old age. The Taiwanese elderly will not only live a long life, but also a healthy and good quality of life.