臺灣老年人的休閒活動與健康益處：系統性回顧

Leisure-time activities and health benefits among older adults in Taiwan: A systematic review

過去休閒活動相關之研究點出，應進一步關注休閒活動在亞洲效益與需求的文獻回顧。本研究系統性地回顧已發表之相關研究，並聚焦於亞洲老年人參與休閒活動與健康之間的關係，與關注臺灣老年人參與各種身體休閒活動和娛樂休閒活動對健康的影響，並探討三個研究問題：一、臺灣老年人的休閒活動如何預測健康效益？二、臺灣老年人參與休閒活動的模式與後續健康效益相關性為何？三、臺灣老年人的休閒活動與健康效益是否因性別而異？透過英文和中文資料庫，包括PubMed、Embase、CINAHL和華藝網，並使用了品質評估工具QualSyst、Newcastle-Ottawa Scale、遵循PRISMA步驟，最後納入了39篇研究。我們發現臺灣老年人參與任何類型的休閒活動，都能產生健康上的好處，但身體休閒活動可預測更多的效益；娛樂休閒活動則與較能夠達到心理社會的效益。整體來說，臺灣老年人參與高強度的身體休閒活動之成效與西方老年人相似，不過對東方老年人而言，參與更多樣的身體休閒活動和娛樂休閒活動，也能更達成相似的健康效益。早期參與、持續提高休閒活動強度、頻率或多樣性，不但可能帶來更加身體和心理健康效益，讓原本健康狀況不佳的老年人，亦能從增加多樣的休閒活動參與獲得健康的好處。不論男女，長期參與身體休閒活動，健康都能受益；而娛樂休閒活動，對老年女性有更多益處。臺灣及亞洲其他國家的政策制定者，應鼓勵老年人參與身體活動之休閒活動為主，同時也輔以娛樂休閒活動，促進參與休閒活動，可做亞洲老年人健康老化的起點。

This study systematically reviewed published research on the associations between leisuretime activities (LTA) and health benefits, specifically focusing on an Asian context—an aspect highlighted for further investigation in the literature on LTA effects. Our study emphasizes the benefits for Taiwanese older adults in engaging in a wider range of leisure-time physical activity (LTPA) and leisure-time recreational activities (LTRA) to achieve desired health benefits. Cultural activity preferences and space issues among older adults in Taiwan were considered in this approach. Three research questions were addressed: (RQ 1) How does LTA participation among older adults in Taiwan predict health benefits? (RQ 2) How do Taiwanese older adults’patterns of engaging in LTA relate to later health benefits? (RQ 3) Do the relationships between LTA and health benefits vary by gender among Taiwanese older adults? A comprehensive literature search was conducted for both English and Chinese databases, including PubMed, Embase, CINAHL, and Airiti. Quality assessment was performed using the quantitative assessment tool QualSyst. This systematic review followed the PRISMA guidelines and was registered in the international prospective register of systematic reviews (PROSPERO) with the number CRD42023461515. This review included 39 articles, all with good-to-strong quality. Although the participation in any type of LTA have health benefits for Taiwanese older adults, LTPA tended to predict more benefits for better physical function, lower risk of mortality, and better psychosocial well-being. On the other hand, LTRA was associated with more indicators for psychosocial well-being, such as fewer depressive symptoms and a lower risk of cognitive decline. Like older adults from Western countries, Taiwanese older adults may benefit from higher intensities of LTPA participation. However, a more culturally appropriate approach for Taiwanese or Asian older adults to achieve desired health benefits involves engaging in a greater variety of LTPA and LTRA. Furthermore, early engagement and continuing increases in intensity, frequency, or variety of LTPA and LTRA may provide greater physical and psychological health benefits. Finally, older men and older women benefit from LTPA longitudinally; older women benefited more than older men from LTRA. Even older adults with poor baseline health could benefit from increasing LTPA and LTRA participation. In light of these findings, policymakers in Taiwan, as well as in other Asian countries, are encouraged to recognize LTPA as a fundamental activity for older adults, and supplement it with LTRA. Promoting healthy aging can be an effective strategy for enhancing the well-being of Asian older adults.