社團法人臺灣臨床藥學會

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【原著】由臺灣中老年長期追蹤調查結果探討行動能力下降趨勢與危險因子
Exploring the Trend of Declining Mobility and Risk Factors: Insights from the Taiwan Longitudinal Study on Aging (TLSA)
中老年身心社會生活狀況長期追蹤調查、老年人、行動能力下降、Taiwan Longitudinal Study on Aging (TLSA), elderly, mobility decline
黃淑萍Shu-Ping Huang1,* 、黃瀅璇Ying-Hsuan Huang1 、陳君敏Chun-Min Chen2
1彰化基督教醫院藥學部 、2淡江大學精準健康學院高齡健康管理學研究所
目的:本研究藉由全國的中老年人問卷調查研究,探討臺灣地區老年人在4年期間行動能力演變趨勢。主要結果評估疾病對行動能力下降的影響,次要結果評估行動能力下降對於醫療資源應用的增加程度。
方法:本研究為回溯性研究,利用衛生福利部衛生福利資料科學中心提供之2011 年及2015 年中老年調查資料,探討臺灣地區中老年人行動能力變化。研究資料包括受訪者的基本資料、一年內住院及急診就醫情形及日常活動量表,量表分數愈高代表行動能力愈差。利用多元羅吉斯回歸進行分析,找出影響活動能力下降的主要危險因子。
結果:本研究於2011 年納入3,727 名受訪者,2015 年再度對其中2,865 人 (76.9%)進行追蹤調查。受訪者中,女性1,470 人 (51.3%),男性1,395 人 (48.7%)。2011 年的日常活動量表平均分數為4.4 ± 6.7,2015 年上升至6.14 ± 8.4。1221 人 (46.6%)出現活動能力下降。多元邏輯斯迴歸分析結果顯示,影響活動能力下降的主要危險因子包括女性 (Odds Ratio [OR] = 1.26, 95% Confidence Interval [CI]: 1.08–1.48)、高血壓 (OR = 1.58, 95%CI: 1.34–1.86)、髖骨骨折 (OR = 1.61, 95%CI: 1.05–2.46) 以及白內障 (OR = 1.88, 95%CI: 1.60–2.21)。
結論:近五成老年人的行動能力會隨著年齡呈現下降趨勢。當老年人行動能力下降,其醫療資源的使用是有顯著的增加,不論是住院人數、人次或天數,還是急診就醫人數與人次。
 
Objective: This study utilizes data from the Taiwan Longitudinal Study on Aging (TLSA) to explore the trend of declining mobility among the elderly. Analyzing TLSA survey results over a four-year period, the research aims to assess the impact of various factors on the observed decrease in mobility among the elderly.
Methods: A retrospective data analysis approach was employed. Information from both the 2011 and 2015 TLSA surveys was extracted. The dataset included demographics, medical service utilization within one year, and a daily activity scale. A higher cumulative score indicated a lower level of mobility. Multiple logistic regression analysis was conducted to identify the primary risk factors contributing to declining mobility.
Results: In 2011, a total of 3,727 participants were surveyed, with a subsequent follow-up in 2015 that included 2,865 of these participants (76.9%). Among these, 1,470 were female (51.3%), and 1,395 were male (48.7%). The average score on the daily activity scale increased from 4.4 ± 6.7 in 2011 to 6.14 ± 8.4 in 2015. Approximately 46.6% (1,221 individuals) exhibited a decline in mobility. The results of the multiple logistic regression analysis revealed that factors influencing declining mobility included being female (odds ratio [OR] = 1.26, 95% confidence interval [CI]: 1.08–1.48), high blood pressure (OR = 1.58, 95% CI: 1.34–1.86), hip fractures (OR = 1.61, 95% CI: 1.05–2.46), and cataracts (OR = 1.88, 95% CI: 1.60–2.21).
Conclusions: The study emphasizes that nearly half of the elderly population experiences a decline in mobility. When the mobility of the elderly declines, their utilization of medical services significantly increases. 
 
 
Submitted for publication: 2023.9.12; Accepted for publication: 2024.3.14
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