题名

臺灣老人失能趨勢之回顧

并列篇名

Review of Disability Trends among Older Adults in Taiwan

DOI

10.6317/LTC.19.157

作者

游曉微(Hsiao-Wei Yu)；陳雅美(Ya-Mei Chen)

关键词

臺灣老人 ； 失能 ； 功能限制 ； 趨勢 ； Taiwan older adults ； disability ； functional limitation ； trends

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

157 - 186

内容语文

繁體中文
中文摘要

瞭解人口老化和失能（disability）盛行率趨勢（trends）有助於訂定長期照護政策。本文旨在回顧臺灣老人過去二十年失能盛行率趨勢，探討不同失能程度盛行率及影響因素，並提出臺灣資料庫建議。彙整盛行率方式係參考美國國家研究院老人失能調查資料庫準則，利用文獻回顧搜尋臺灣多個老人調查資料庫及研究。結果發現，臺灣老人在相對輕度的失能項目，包括：Nagi功能限制和工具性日常生活功能（instrumental activities of daily living, IADL）失能的盛行率雖在不同資料庫結果不一致，但部分研究顯示失能盛行率已出現下降趨勢；在相對嚴重的失能項目，包括：日常生活功能（activities of daily living, ADL）失能的盛行率趨勢則是一致上升。臺灣老人不同失能程度盛行率差異可能和全民健保施行、外籍看護工居家照顧、基礎建設和科技進步等因素有關。最後，針對臺灣老人失能調查資料庫建議，包括建立國內老人功能和健康調查的設計共識指標、不同失能程度宜分開調查、致力於促進健康或環境改善等積極降低老人失能的具體措施。
英文摘要

Understanding ageing and disability trends in older adults is important for long-term care policymaking. This study aims to review the disability trends of the past two decades among older Taiwanese adults and examines factors that may influence these trends. Referencing criteria used to qualify disability surveys of older adults that were conducted by the US National Research Council, we estimated the disability trends of older Taiwanese adults in several Taiwanese ageing surveys. The results showed that mild to moderate types of disability trends, such as Nagi's functional limitation and instrumental activities of daily living (IADL), were mixed and exhibited declining prevalence; however, severe types of disability trends such as activities of daily living (ADL) consistently increased in Taiwan within the reviewed years. Potential explanations for the development of different disability trends may result from universal health insurance benefits, the introduction of foreign caregivers, and infrastructure and technological improvements. Other recommendations for improving the quality of ageing and disability surveys in Taiwan are as follows: establish a consensus regarding the assessment of functional and health indicators in older adults, evaluate functional limitation and disability separately, and devote efforts to prevent disability in older adults (e.g. promotion of health and environmental modifications).
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. Chuang, K. Y.,Chuang, Y. C.,Chen, L. J.,Wu, S. C.(2008).Geographical variations in elderly disability in Taiwan.The Journal of Nursing Research,16(1),47-54.
    連結：
  2. Barberger-Gateau, P.,Rainville, C.,Letenneur, L.,Dartigues, J. F.(2000).A hierarchical model of domains of disablement in the elderly: A longitudinal approach.Disability and Rehabilitation,22(7),308-317.
  3. Chang, W. C.,Lu, F. P.,Lan, T. Y.,Wu, S. C.(2013).Multidimensional healthtransition patterns among a middle-aged and older population.Geriatrics & Gerontology Internatonal,13(3),571-579.
  4. Chao, S. F.(2012).Functional disability and psychological well-being in later life: Does source of support matter?.Aging & Mental Health,16(2),236-244.
  5. Chen, C. M.,Chang, W. C.,Lan, T. Y.(2014).Identifying factors associated with changes in physical functioning in an older population.Geriatrics & Gerontology Internatonal
  6. Chen, C. M.,Su, Y. Y.,Lan, T. Y.,Mullan, J.,Shi, H. Y.,Chiu, H. C.(2013).Health-related services use and the onset of functional disability: 10 year follow-up study.Archives of Gerontology and Geriatrics,58(3),356-363.
  7. Chen, L. Y.,Liu, L. K.,Liu, C. L.,Peng, L. N.,Lin, M. H.,Chen, L. K.,Chang, P. L.(2013).Predicting functional decline of older men living in veteran homes by minimum data set: Implications for disability prevention programs in long term care settings.Journal of the American Medical Directors Association,14(4),309.e9-309.e13.
  8. Cheng, S. H.,Chiang, T. L.(1997).The effect of universal health insurance on health care utilization in Taiwan. Results from a natural experiment.The Journal of the American Medical Association,278(2),89-93.
  9. Chiu, C. J.,Wray, L. A.,Ofstedal, M. B.(2011).Diabetes-related change in physical disability from midlife to older adulthood: Evidence from 1996-2003 Survey of Health and Living Status of the Elderly in Taiwan.Diabetes Research and Clinical Practice,91(3),413-423.
  10. Chou, K. L.,Leung, J. C. B.(2008).Disability trends in Hong Kong community-dwelling Chinese older adults: 1996, 2000, and 2004.Journal of Aging and Health,20(4),385-404.
  11. Christensen, K.,Doblhammer, G.,Rau, R.,Vaupel, J. W.(2009).Ageing populations: The challenges ahead.Lancet,374(9696),1196-1208.
  12. Crimmins, E. M.(1996).Mixed trends in population health among older adults.The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,51(5),S223-S225.
  13. Freedman, V. A.,Martin, L. G.,Schoeni, R. F.(2002).Recent trends in disability and functioning among older adults in the United States- A systematic review.The Journal of the American Medical Association,288(24),3137-3146.
  14. Freedman, V. A.,Martin, L. G.,Schoeni, R. F.,Cornman, J. C.(2008).Declines in late-life disability: The role of early- and mid-life factors.Social Science & Medicine,66(7),1588-1602.
  15. Freedman, V. A.,Soldo, B. J.(1994).Trends in disability at older ages: Summary of a workshop.Washington, D.C.:The National Academies Press.
  16. Fried, T. R.,Bradley, E. H.,Williams, C. S.,Tinetti, M. E.(2001).Functional disability and health care expenditures for older persons.Archives of Internal Medicine,161(21),2602-2607.
  17. Fries, J. F.(1980).Aging, natural death, and the compression of morbidity.The New England Journal of Medicine,303(3),130-135.
  18. Fries, J. F.,Bruce, B.,Chakravarty, E.(2011).Compression of morbidity 1980-2011: A focused review of paradigms and progress.Journal of Aging Research
  19. Gill, T. M.,Baker, D. I.,Gottschalk, M.,Peduzzi, P. N.,Allore, H.,Byers, A.(2002).A program to prevent functional decline in physically frail, elderly persons who live at home.The New England Journal of Medicine,347(14),1068-1074.
  20. Gruenberg, E. M.(1977).The failures of success.The Milbank Memorrial Fund Quarterly, Health and Society,55(1),3-24.
  21. Hashimoto, S.,Kawado, M.,Seko, R.,Murakami, Y.,Hayashi, M.,Kato, M.,Tsuji, I.(2010).Trends in disability-free life expectancy in Japan, 1995-2004.Journal of Epidemiology,20(4),308-312.
  22. Hsu, H. C.(2005).Gender disparity of successful aging in Taiwan.Women & Health,42(1),1-21.
  23. Hsu, H. C.(2009).Physical function trajectories, depressive symptoms, and life satisfaction among the elderly in Taiwan.Aging & Mental Health,13(2),202-212.
  24. Hsu, H. C.,Tung, H. J.(2011).Coping strategies and adaptation for the disabled elderly in Taiwan.Geriatrics & Gerontology International,11(4),488-495.
  25. Huang, J. F.,Wong, R. H.,Chen, C. C.,Mao, I. F.,Huang, C. C.,Chang, W. H.,Wang, L.(2011).Trajectory of depression symptoms and related factors in later life-A population based study.Journal of Affective Disorders,133(3),499-508.
  26. Katz, S.,Ford, A. B.,Moskowitz, R. W.,Jackson, B. A.,Jaffe, M. W.(1963).Studies of illness in the aged. The index of ADL: A standardized measure of biological and psychosocial function.The Journal of the American Medical Association,185,914-919.
  27. Lafortune, G.,Balestat, G.(2007).OECD Health Working PapersOECD Health Working Papers,未出版
  28. Lawton, M. P.,Brody, E. M.(1969).Assessment of older people: Self-maintaining and instrumental activities of daily living.The Gerontologist,9(3),179-186.
  29. Liang, J.,Wang, C. N.,Xu, X. A.,Hsu, H. C.,Lin, H. S.,Lin, Y. H.(2010).Trajectory of functional status among older Taiwanese: Gender and age variations.Social Science & Medicine,71(6),1208-1217.
  30. Liao, W. C.,Li, C. R.,Lin, Y. C.,Wang, C. C.,Chen, Y. J.,Yen, C. H.,Lee, M. C.(2011).Healthy behaviors and onset of functional disability in older adults: Results of a national longitudinal study.Journal of the American Geriatrics Society,59(2),200-206.
  31. Lin, K. C.,Chi, L. Y.,Twisk, J. W.,Lee, H. L.,Chen, P. C.(2011).Trajectory stability and factors affecting trajectories over time of the longitudinal age-related change in physical performance among older people.Experimental Aging Research,37(3),358-376.
  32. Manton, K. G.(1982).Changing concepts of morbidity and mortality in the elderly population.The Milbank Memorial Fund Quarterly Health and Society,60(2),183-244.
  33. Martin, L. G.,Zimmer, Z.,Hurng, B. S.(2011).Trends in late-life disability in Taiwan, 1989-2007: The roles of education, environment, and technology.Population Studies: A Journal of Demography,65(3),289-304.
  34. Moe, J. O.,Hagen, T. P.(2011).Trends and variation in mild disability and functional limitations among older adults in Norway, 1986-2008.European Journal of Ageing,8(1),49-61.
  35. Nagi, S. Z.(1965).Some conceptual issues in disability and rehabilitation.Washington, DC:American sociological Association.
  36. Ofstedal, M. B.,Zimmer, Z.,Hermalin, A. I.,Chan, A.,Chuang, Y. L.,Natividad, J.,Tang, Z.(2007).Short-term trends in functional limitation and disability among older Asians: A comparison of five Asian settings.Journal of Cross-Cultural Gerontology,22(3),243-261.
  37. Pan, L. Y.,Hsu, H. C.,Chang, W. C.,Luh, D. L.(2014).Trajectories of physical activity and risk factors among Taiwanese older adults.International Journal of Behavioral Medicine,4,4.
  38. Parker, M.,Schon, P.,Lagergren, M.,Thorslund, M.(2008).Functional ability in the elderly Swedish population from 1980 to 2005.European Journal of Ageing,5(4),299-309.
  39. Ross, C. E.,Wu, C. L.(1996).Education, age, and the cumulative advantage in health.Journal of Health and Social Behavior,37(1),104-120.
  40. Scott, W. K.,Macera, C. A.,Cornman, C. B.,Sharpe, P. A.(1997).Functional health status as a predictor of mortality in men and women over 65.Journal of Clinical Epidemiology,50(3),291-296.
  41. Tsai, A. C.,Lai, T. M.(2011).Predicting the need of formal care in Taiwan: Analysis of a national random sample.Archives of Gerontology and Geriatrics,53(3),298-302.
  42. Verbrugge, L. M.,Jette, A. M.(1994).The disablement process.Social Science & Medicine,38(1),1-14.
  43. Waidmann, T. A.,Manton, K. G.(1998).International evidence on disability trends among elderly.Washington, D.C.:Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.
  44. Wang, C. Y.,Yeh, C. J.,Hu, M. H.(2011).Mobility-related performance tests to predict mobility disability at 2-year follow-up in community-dwelling older adults.Archives of Gerontology Geriatrics,52(1),1-4.
  45. Wen, C. P.,Tsai, S. P.,Chung, W. S.(2008).A 10-year experience with universal health insurance in Taiwan: measuring changes in health and health disparity.Annals of Internal Medicine,148(4),258-267.
  46. Wu, S. C.,Leu, S. Y.,Li, C. Y.(1999).Incidence of and predictors for chronic disability in activities of daily living among older people in Taiwan.Journal of the American Geriatrics Society,47(9),1082-1086.
  47. Zheng, X. Y.,Chen, G.,Song, X. M.,Liu, J. F.,Yan, L. J.,Du, W.,Zhang, J.(2011).Twenty-years trends in the plevalence of disability in China.Bulletin of the World Health Organization,89(11),788-797.
  48. Zimmer, Z.,Liu, X.,Hermalin, A.,Chuang, Y. L.(1998).Educational attainment and transitions in functional status among older Taiwanese.Demography,35(3),361-375.
  49. Zimmer, Z.,Martin, L. G.,Chang, M. C.(2002).Changes in functional limitation and survival among older Taiwanese, 1993, 1996, and 1999.Population Studies: A Journal of Demography,56(3),265-276.
  50. Zimmer, Z.,Martin, L. G.,Jones, B. L.,Nagin, D. S.(2014).Examining late-life functional limitation trajectories and their associations with underlying onset, recovery, and mortality.The Journals of Gerontology Series B: Psychological Sciences and Social Sciences,69(2),275-286.
  51. 行政院內政部（1996）。老人狀況調查報告：民國 85 年。臺北：作者。
  52. 行政院內政部（2009）。老人狀況調查報告：民國 98 年。臺北：作者。
  53. 行政院內政部（2005）。老人狀況調查報告：民國 94 年。臺北：作者。
  54. 行政院內政部（2000）。老人狀況調查報告：民國 89 年。臺北：作者。
  55. 行政院內政部（2011）。民國 100 年身心障礙者生活狀況及各項需求評估調查結果摘要分析。2014 年 7 月 15 日取自http://sowf.moi.gov.tw/stat/Survey/身障/100年/100年身心障礙者生活狀況及各項需求評估調查結果中文摘要分析.pdf
  56. 行政院內政部（2002）。老人狀況調查報告：民國 91 年。臺北：作者。
  57. 行政院內政部（1993）。老人狀況調查報告：民國 82 年。臺北：作者。
  58. 行政院主計總處（2000）。人口及住宅普查：民國 89 年。2014 年 7 月 9 日取自http://www.dgbas.gov.tw/np.asp?ctNode=2834
  59. 行政院主計總處（2005）。社會發展趨勢調查（健康安全）：民國 94 年。2014 年 7月 9 日取自 http://win.dgbas.gov.tw/dgbas03/ca/society/Health-94/
  60. 行政院主計總處（2010）。人口及住宅普查：民國 99 年。2014 年 7 月 9 日取自http://www.dgbas.gov.tw/np.asp?ctNode=2834
  61. 行政院主計總處（2001）。社會發展趨勢調查（健康安全）：民國 90 年。2014 年 7月 9 日取自 http://win.dgbas.gov.tw/dgbas03/ca/society/Health-90/index.html
  62. 行政院勞工委員會（1992）。因應家庭照顧殘障人力短缺暫行措施。2014 年 8 月 3日取自 http://www.wda.gov.tw/
  63. 行政院經濟建設委員會,行政院衛生署,內政部,行政院勞工委員會,行政院原住民族委員會,行政院國軍退除,兵輔導委員會(2009)。,臺北:行政院經濟建設委員會。
  64. 行政院衛生署（2010）。2010 年國民長期照護需要調查。
  65. 行政院衛生署國民健康局（1996）。民國 85年臺灣地區中老年保健與生涯規劃調查。2014 年 6 月 30 日取自 http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  66. 行政院衛生署國民健康局（2007）。民國 96年臺灣地區中老年身心社會生活狀況長期追蹤調查。2014 年 6 月 30 日取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  67. 行政院衛生署國民健康局（1993）。民國 82年老人保健與生活問題長期研究。2014年 6 月 30 日取自 http://www.hpa.gov.tw/BHPnet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  68. 行政院衛生署國民健康局（2009）。老人健康促進計畫 2009-2012。2014 年 8 月 10日取自 http://www.hpa.gov.tw/BHPNet/Web/Index/Index.aspx
  69. 行政院衛生署國民健康局（2011）。民國 100年臺灣地區中老年身心社會生活狀況長期追蹤調查。2014 年 6 月 30 日取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  70. 行政院衛生署國民健康局（1999）。民國 88年臺灣地區中老年身心社會生活狀況長期追蹤調查。2014 年 6 月 30 日取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  71. 行政院衛生署國民健康局（2003）。民國 92年臺灣地區中老年身心社會生活狀況長期追蹤調查。2014 年 6 月 30 日取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  72. 行政院衛生署國民健康局（1989）。民國 78年臺灣地區老人保健與生活問題調查表。2014 年 6 月 30 日取自 http://www.hpa.gov.tw/BHPnet/Web/HealthTopic/TopicArticle.aspx?No=201106080002&parentid=200712270002
  73. 財團法人國家衛生研究院、行政院衛生署國民健康局（2009）。民國 98 年國民健康訪問調查。取自 http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=201203210001&parentid=200712270001
  74. 財團法人國家衛生研究院、行政院衛生署國民健康局（2001）。民國 90 年臺閩地區國民健康訪問調查 。取自http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=200712270001&parentid=200712270001
  75. 財團法人國家衛生研究院、行政院衛生署國民健康局（2005）。民國 94 年國民健康訪問調查。取自 http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?No=200712270007&parentid=200712270001
被引用次数
  1. 黃惠子,陳秋燕,林玉茹,李秋香(2019)。出院後居家老人面對行動失能的調適歷程。嘉基護理，19(2)，15-26。
  2. 鐘子婷,黃瑋絜,陳雅美,杜裕康,吳世權(2022)。台灣中老年族群失能率趨勢：以中老年身心社會生活狀況長期追蹤調查重新驗證。台灣公共衛生雜誌，41(3)，347-357。
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