生理、認知、社會衰弱、及多面向衰弱之文獻回顧

Literature review of physical, cognitive, social, and multidimensional frailty

台灣於2018年正式邁入高齡社會，隨老年人口快速成長，慢性病與功能障礙盛行率急遽上升，失能人口大幅增加，對國家長照體系及財源負擔接帶來很大的挑戰，因此，如何預防長者邁入失能階段、健康老化成為各國關注的議題。衰弱是介於健康與失能之間的連續狀態，具可復原性，可經由有效介入恢復健康狀態，避免長者進入到不可逆的失能期。本文綜覽國內外生理、認知、社會多面向衰弱相關研究，回顧衰弱相關研究的發展現況及提出研究缺口。與國際相較，我國尚缺乏認知、社會、及多面向衰弱相關研究，作者提出三點建議：第一，發展符合台灣民情之社會衰弱量表；第二，增加發展社會衰弱相關研究，如其盛行率、風險因子、與不良健康結果間的關聯等；第三，從多維觀點探討衰弱議題，研析生理、認知、社會衰弱三者互相作用之機轉，並以研究實證多面向衰弱評估量表之信、效度，從更全面的角度評估長者健康，達到預防不良健康結果的作用。

As the elderly population increases in Taiwan, the prevalence of chronic diseases and functional disability has risen sharply. Consequently, long-term care and financial systems can quickly become overburdened. Therefore, preventing disabilities among older adults and ensuring healthy aging are essential. Older adults often experience frailty, which is a predisability state; however, frailty is reversible, and older adults can return to a normal state through interventions. This review analyzed studies on physical, cognitive, social, and multidimensional frailty and provides an overview of research on frailty in Taiwan and abroad. Because additional studies on cognitive, social, and multidimensional frailty should be conducted in Taiwan, this review offers three suggestions: (a) A Taiwanese social frailty assessment tool should be developed; (b) further research on social frailty and its prevalence, risk factors, and relationship to adverse outcomes should be conducted; and (c) the mechanisms among aspects of frailty should be further investigated. Studies should evaluate the reliability and validity of multidimensional frailty assessment tools to screen for frailty among older adults in Taiwan more effectively.