預測台灣社區長者衰弱轉換惡化之身體、心理及社會層面因子：縱貫性研究

Predictors of worsening frailty transitions in Taiwanese community-dwelling older adults: a longitudinal study

目標：衰弱是高齡社會面臨的重要健康議題，其對個人、家庭及社會影響深遠。近年「衰弱轉換」備受關注，研究顯示衰弱轉換惡化顯著提高失能與死亡風險，凸顯早期診斷與介入的重要性。衰弱受身體、心理與社會多面向影響，然而這些因素如何影響衰弱轉換惡化仍有待釐清。因此，本研究旨在探討社區長者衰弱轉換惡化之多面向預測因子。方法：採用衛生福利部2007及2011年「台灣地區中老年身心社會生活狀況長期追蹤調查」資料，納入1,670位60歲（含）以上之長者。以衰弱轉換惡化為依變項，將身體、心理及社會層面因素作為自變項。分析方法包括描述性統計及羅吉斯迴歸分析。結果：研究發現30.2%的社區長者經歷衰弱轉換惡化。關節炎或風濕症、抽菸行為、年齡及教育程度則為顯著預測因子。結論：衰弱轉換惡化在社區長者中具相當高的發生率。健康照護人員應採取整合性衰弱管理策略，特別關注罹患關節炎或風濕性疾病、有吸菸史、高齡及不識字的長者，以提升早期預防與介入的成效。

Objectives: Frailty is a major health concern in aging societies and has substantial effects on individuals, families, and communities. Researchers have recently shifted their attention to frailty transitions, with evidence indicating that worsening frailty transitions markedly increase the risks of disability and mortality; therefore, early intervention is crucial. Although physical, psychological, and social factors influence frailty, their roles in worsening frailty transitions remain unclear. Accordingly, this study explored key predictors of worsening frailty transitions in community-dwelling older adults. Methods: This longitudinal study included 1,670 community-dwelling adults aged≥60 years. Relevant data were collected from the Taiwan Longitudinal Study on Aging (2007–2011). The data were analyzed using descriptive statistics and multiple logistic regression models. In the statistical models, the dependent variable was worsening frailty transitions, whereas the independent variables were physical, psychological, and social factors. Results: Approximately 30.2% of the included older adults exhibited worsening frailty transitions. Significant predictors of this trend included arthritis or rheumatism, smoking habits, advanced age, and low educational attainment. Conclusions: Worsening frailty transitions are common in community-dwelling older adults. For early prevention of worsening frailty transitions, health-care professionals should implement comprehensive management strategies, particularly targeting older adults with arthritis or rheumatism, a history of smoking, advanced age, or low educational attainment.