高齡者久坐行為與健康之文獻回顧

A review of sedentary behavior and health in older adults

久坐行為已經成為影響健康的重要危險因子。高齡者經常花費過量的時間在久坐行為活動上。國外已經有許多研究證實久坐行為會提升高齡者罹患疾病與死亡的風險，但有關久坐行為與健康結果的關係仍未被完整探討。本研究旨在透過有關高齡者久坐行為與各種疾病的流行病學研究證據，提出一敘述性的綜論供國內久坐行為臨床研究與實務之參考。本文採用文獻回顧方法搜尋PUBMED資料庫2007年1月至2016年12月的相關文獻，經搜尋與排除條件檢核後，共19篇文章符合篩選標準。結果發現高齡者長時間久坐行為會提高全死因死亡率之風險；久坐行為與糖尿病、代謝症候群和過重肥胖之關係有一致性的結果；久坐行為與腎臟惡性腫瘤之關係仍未被發現。本研究之文獻回顧結果支持久坐行為與高齡者健康之間的關係。未來相關研究宜採用大樣本調查與縱貫性研究設計，並應考量納入本研究所提之干擾因素較有研究證據力。此外，未來宜持續探討不同久坐行為類型（休閒、通勤、工作及家庭層面）對高齡者健康的影響，並建議同時採用主觀及客觀方式測量久坐行為。

Sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their waking time in sedentary activities. Despite the fact that several studies have demonstrated the impact of sedentary behavior on the health of older adults, few studies have been done with an older Taiwanese population. We systematically reviewed epidemiologic evidence for associations between sedentary behavior and multiple health outcomes in older adults in order to provide crucial information for clinical research and practice. We searched the PUBMED database for observational studies published from January 2007 to December 2016, and found 19 eligible articles. The results showed that greater sedentary time was related to an increased risk of mortality from all causes in older adults. Some studies showed consistent results and indicated a relationship between sedentary behavior and metabolic syndrome, overweight/obesity, and diabetes; the findings relative to cancer remain insufficient to draw conclusions. This systematic review supported the relationship between sedentary behavior and mortality in older adults. Further research on this topic should utilize a nationally representative sample, a large-scale prospective cohort study, and adjustment for multiple confounders. Furthermore, investigations of an ecologic model with different domains of sedentary behavior and data collection with a combination of subjective and objective measures of sedentary behavior are recommended.