台灣地區高齡人口存活之相關因素探討

Factors Associated with Survival Status of Order Taiwanese Adults

10.6288/TJPH2006-25-05-04

林正祥(Cheng-Hsiang Lin)；林惠生(Hui-Sheng Lin)

老人健康調查 ； 存活狀況 ； Cox比例風險模式 ； survey of health and living status of the elderly ； survival status ； Cox proportional hazard model

台灣公共衛生雜誌

25卷5期（2006 / 10 / 01）

351 - 362

繁體中文

目標：探討台灣地區高齡人口存活之因素。方法：本研究利用1989年「台灣地區老人保健與生活問題調查」，歷時十年之資料以Cox比例風險模式分析與老人存活之相關因素。根據以往文獻我們共選擇了與老人存活有密切關聯的15個重要變項並以此建構6組模式，包括背景特徵、身心狀況、家庭環境、社會參與及衛生行為之組合並分別就各模式間差異探討之。結果：研究結果顯示身心狀況(ADL、體能狀況和健康自評)對老人的存活影響至鉅，換句話說，除了一些人口變項外，健康的身體及獨立活動的能力，遠甚於教育程度、經濟狀況及抑鬱程度對老人存活的影響。此外，配偶存在亦有降低死亡風險的作用。我們亦探討了在這些變項同時存在時各變項之死亡風險，並針對在控制其他變項平均值時各重要變項之老人調整存活機率做了一些說明。另外，也討論了在人口變項組合（年齡＋性別＋族群）之風險。結論：經統計模式選擇，選出了年齡、體能狀況、健康自評、ADL狀況、性別、有無配偶、族群、社團活動、抽煙年數、嚼檳榔年數等十個變項之模式，其可視為影響老人存活的重要指標且足以預測老人存活狀況。另外，本研究中6組模式藉由不同變項組合來解釋影響老人存活狀況，可因探討目的不同而相互比較分析。

Objective: To investigate the factors associated with survival status of the elderly in Taiwan. Methods: The impact of factors on the survival status of older Taiwanese during the 10 year interval from April 1989 to April 1999 was examined. Data was derived from the Taiwan Survey of Health & Living Status of the Elderly, as published in 1989, 1992, 1996, and 1999. The Cox proportional model was used for data analysis. Results: With the exception of some demographic variables, ADL function, physical function, and self-rated health, had a much stronger relationship to the survival status of the elderly in Taiwan than did education, economic status, and depression. In addition, we (i) discussed the risk ratio of the impact factors on survival status, (ii) investigated the adjusted survival curve of some important factors, and (iii) explored the risk ratio of combined demographic variables (i.e., age + gender + marital status) of the Taiwanese elderly. Conclusion: Based on model selection, ten factors were strongly related to the survival status of the elderly: age, gender, ethnicity, marital status, social participation, self-rated health, Ssmoking, consumption of areca nuts, ADL function, and physical function. These variables had a good prediction index for survival status of the elderly in Taiwan. However, the six models utilized in this study can be compared with each other for specific research purposes.

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