题名

高齡者的失能預防

并列篇名

Prevention of Disability in the Elderly

DOI

10.6317/LTC.19.149

作者

陳喬男(Joyce Chiao-Nan Chen)

关键词

失能 ; 老年人 ; 運動 ; 飲食 ; 預防 ; Disability ; elderly ; exercise ; diet ; prevention

期刊名称

長期照護雜誌

卷期/出版年月

19卷2期(2015 / 09 / 01)

页次

149 - 155

内容语文

繁體中文

中文摘要

隨著高齡人口逐漸增加,了解造成高齡者失能的原因及其預防方法至為重要,其將有助高齡者維持體能活動能力,得以扮演在家庭社會之角色。高齡者的失能與身體的衰弱程度緊密相關。身體之衰弱常表現在自覺之疲憊感、肌肉無力、體能活動力下降,以及疾病抵抗能力下降。老化、疾病及缺乏運動是造成個體衰弱的主因。老化伴隨之骨骼肌質量與力量的下降,導致高齡者走路速度變慢、跌倒機率增加、獨立生活能力下降,並增加高齡者入住養護機構的比例。阻力型運動,配合足夠之蛋白質攝取,為增加高齡者骨骼肌質量的黃金處方。另外,與老化相關之疾病,如心臟病、中風、退化性關節炎、與跌倒造成之骨折常降低高齡者活動的意願與能力。飲食及多面向運動可有效改善高齡者身體代謝異常的情形,並增加其骨質密度與平衡能力,有效預防老化相關疾病的發生。總結來說,適當的飲食與運動可增加高齡者具備獨立生活能力的壽命,減少其失能的時間,達到增加個體與照顧者生活品質的目標。

英文摘要

Disability is the term describing the impairment of body function of individuals that limits the activities that they can perform and restricts the participation that they can involve in the life. As the elderly population rises continuously, it is important to understand the causes of the disability in the elderly and the strategies to prevent it. Frailty characterized by slow walking speed, muscle weakness, feeling exhaustion, decreased physical activity and loss of lean body mass is the major cause of disability in the elderly. Risk factors of frailty are age, diseases and lake of exercise. Age-related loss of muscle mass and strength is the central and paramount factor of frailty in the elderly. Progressive resistance exercise accompanied with sufficient protein intake effectively increase muscle strength and lean body mass of the elderly. Age-related diseases such as heart diseases, stroke, osteoarthritis and fall-related fracture also decrease the exercise capacity of the elderly and negatively affect the willingness of individuals to exercise. Multidimensional exercises and diet intervention including calorie restriction and vitamin D supplementation not only increase physical function and reduce fall incidences of the elderly but also improve metabolic impairment that is associated with age-related diseases. In conclusion, adequate diet strategies and exercise regimen play an important role to prevent or postpone the disability in the elderly.

主题分类 醫藥衛生 > 預防保健與衛生學
醫藥衛生 > 社會醫學
参考文献
  1. Anderson, G. L.,Judd, H. L.,Kaunitz, A. M.,Barad, D. H.,Beresford, S. A.,Pettinger, M.,Lopez, A. M.(2003).Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: The women's health initiative randomized trial.The Journal of the American Medical Association,290(13),1739-1748.
  2. Anton, S. D.,Karabetian, C.,Naugle, K.,Buford, T. W.(2013).Obesity and diabetes as accelerators of functional decline: Can lifestyle interventions maintain functional status in high risk older adults?.Experimental Gerontology,48(9),888-897.
  3. Bauer, J.,Biolo, G.,Cederholm, T.,Cesari, M.,Cruz-Jentoft, A. J.,Morley, J. E.,Boirie, Y.(2013).Evidence-based recommendations for optimal dietary protein intake in older people: A position paper from the PROT-AGE Study Group.Journal of the American Medical Directors Association,14(8),542-559.
  4. Beenakker, K. G.,Ling, C. H.,Meskers, C. G.,de Craen, A. J.,Stijnen, T.,Westendorp, R. G.,Maier, A. B.(2010).Patterns of muscle strength loss with age in the general population and patients with a chronic inflammatory state.Ageing Research Reviews,9(4),431-436.
  5. Burton, L. A.,Sumukadas, D.(2010).Optimal management of sarcopenia.Clinical Interventions in Aging,5,217-228.
  6. Fiatarone, M. A.,O'Neill, E. F,Ryan, N. D.,Clements, K. M.,Solares, G. R.,Nelson, M. E.,Evans, W. J.(1994).Exercise training and nutritional supplementation for physical frailty in very elderly people.New England Journal of Medicine,330(25),1769-1775.
  7. Fried, L. P.,Tangen, C. M.,Walston, J.,Newman, A. B.,Hirsch, C.,Gottdiener, J.,McBurnie, M. A.(2001).Frailty in older adults: Evidence for a phenotype.The Journals of Gerontology Series A: Biological Sciences and Medical Sciences,56(3),M146-M157.
  8. Gatto, S.,Gimigliano, F.,Gimigliano, R.,Iolascon, G.(2011).Prevention of falls and role of calcium and vitamin D.Aging Clinical and Experimental Research,23,20-21.
  9. Karlsson, M. K.,Magnusson, H.,von Schewelov, T.,Rosengren, B. E.(2013).Prevention of falls in the elderly: A review.Osteoporosis International,24(3),747-762.
  10. Lamberts, S. W. J.,van den Beld, A. W.,van der Lely, A. J.(1997).The endocrinology of aging.Science,278(5337),419-424.
  11. Peterson, M. D.,Gordon, P. M.(2011).Resistance exercise for the aging adult: Clinical implications and prescription guidelines.American Journal of Medicine,124(3),194-198.
  12. Sitnick, M.,Bodine, S. C.,Rutledge, J. C.(2009).Chronic high fat feeding attenuates load-induced hypertrophy in mice.The Journal of Physiology,587(23),5753-5765.
  13. Tak, E.,Kuiper, R.,Chorus, A.,Hopman-Rock, M.(2013).Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: A meta-analysis.Ageing Research Reviews,12(1),329-338.
  14. Vermeulen, A.(2001).Androgen replacement therapy in the aging male-- A critical evaluation.The Journal of Clinical Endocrinology & Metabolism,86(6),2380-2390.
  15. Vermeulen, J.,Neyens, J. C.,van Rossum, E.,Spreeuwenberg, M. D.,de Witte, L. P.(2011).Predicting ADL disability in community-dwelling elderly people using physical frailty indicators: A systematic review.BMC Geriatrics,11,33.
  16. World Health Organization. (2015). Health topics: Disabilities. Retrieved from http://www.who.int/topics/disabilities/en/
  17. Writing Group for the Women's Health Initiative Investigators(2002).Risks and benefits of estrogen plus progestin in healthy postmenopausal women: Principal results from the women's health initiative randomized controlled trial.The Journal of the American Medical Association,288(3),321-333.
  18. Zheng, G.,Huang, M.,Liu, F.,Li, S.,Tao, J.,Chen, L.(2015).Tai chi chuan for the primary prevention of stroke in middle-aged and elderly adults: A systematic review.Evidence-based Complementary and Alternative Medicine,2015,742152.
  19. 國家發展委員會(2014)。中華民國人口推計(103 至 150 年)。 臺北:作者。
  20. 陳采㚬,陳慶餘,胡名霞(2012)。運動介入對衰弱老年人健康促進之效益。長期照護雜誌,16(2),107-120。
被引用次数
  1. 蔡昀蓁、楊淑慧、張嘉珣(2018)。運用周全性老年評估照護一位反覆肺炎住院長者之護理經驗。榮總護理,35(3),322-329。
  2. 陳家羚,莊淑娸,張歆妤,江勁政(2022)。從WHO 2020身體活動指引觀點探討肌力與平衡能力對高齡者之重要性。運動表現期刊,9(2),79-91。
  3. 蘇韻如,邱雅雯(2020)。運用出院準備銜接長期照顧2.0服務照護一位失能個案之護理經驗。新臺北護理期刊,22(2),143-151。
  4. 謝錦城、賓孟晨、梁淯傑、洪彰岑、何健章、甘能斌(2017)。環狀運動對老年人下肢功能性體適能與步態穩定性之影響。運動生理暨體能學報,24,1-10。