高齡者認知衰弱之概念分析

Cognitive Frailty in Older Adults: A Concept Analysis

伴隨高齡化社會來臨，如何健康老化成為高齡照護的主要目標，致使預防失智與失能逐漸備受關注。衰弱不再侷限於生理層面，面對失智症等不可逆的認知疾病，認知衰弱的早期評估與預防更勝重要。本文以Walker和Avant（2019）概念分析步驟，統整高齡者認知衰弱之定義，先廣泛查證概念定義，以清楚陳述認知衰弱為：（1）主觀認知減退或輕度認知障礙、（2）需排除為阿茲海默症或其他類型的失智症、（3）同時具有生理衰弱以及（4）具可逆性等定義性特徵；再以典型、邊緣與相反案例來做認知衰弱的概念說明。最後，確認影響認知衰弱的前因後果與評析常用的實證性測量工具。期望藉此概念分析，增進護理人員瞭解認知衰弱概念，將此應用於臨床照護或研究上。

Healthy aging is the primary goal of healthcare for older adults in aging societies. The prevention of physical disabilities and dementia is becoming more important. As frailty involves both the physical and cognitive domains, detecting and preventing cognitive frailty early on is key to reversing cognitive diseases such as dementia. In this study, a concept analysis strategy (Walker & Avant, 2019) was applied to define the concept of cognitive frailty in older adults and identify the attributes of (1) presence of subjective cognitive decline or mild cognitive impairment, (2) exclusion of concurrent Alzheimer's disease or other dementia, (3) concomitant physical frailty, and (4) it is revisable. Using the constructed model, borderline and contrary cases were used to explain the concept of cognitive frailty. Finally, the antecedent and consequence factors of cognitive frailty were identified and the empirical measurement tools were evaluated. This analysis may be used to improve nurses' understanding of cognitive frailty in older adults and to benefit clinical practice and further research.