生活壓力事件對台灣社區老年人成功老化狀態 之關聯性研究

Abstract

摘要 背景 隨著全世界人口老化速度愈來愈快，老化相關的健康議題愈來愈重要。為了讓高齡者維持良好的生活品質，如何使中老年人「成功」的老化受到關注。然而，過去有關成功老化的研究定義及評估方法並不一致。且多數著重於探討身體及生理上的健康，心理相關的因子相對缺乏。因此，本研究旨在探討台灣社區老年人的生活壓力事件與成功老化間之關係。

方法與材料 本研究為一橫斷性研究，受試者資料來自一項正在進行之世代追蹤研究的第二次追蹤（2015-2017）。原世代追蹤計畫之受試者為2011-2013年（基線）參與台大醫院老人健康檢查的65歲及以上長者，最後納入本研究分析的長者共389名。生活壓力事件使用社會再適應量表（SRRS）進行評估，其包括43個生活事件與各事件分數加總而成的量表總分，SRRS總分和生活壓力事件數量更進一步分為高、中與低三組。本研究收集14個不同的變項來評估成功老化，並將這些變項進行因素分析以找出三個成功老化的構面。使用多元線性迴歸和邏輯斯迴歸模型並調整重要共變項來評估生活壓力事件與成功老化之關聯。

結果 本研究找出華人社區老人成功老化的三個構面，分別為「身體及認知功能」、「自我觀點及疾病負擔」與「家庭及社會參與」。本研究發現當過去一年發生愈多的生活壓力事件，高齡者在「整體成功老化」（β = -0.40）以及「自我觀點及疾病負擔」（β = -0.12；OR = 0.77）構面還有「家庭及社會參與」構面（β = -0.05）的表現會愈差；生活壓力事件數偏低的組別（< 3件）在「身體及認知功能」構面的表現比事件數適中的組別（3 - 6件）差（β = -0.23；OR = 0.54）；高齡者的LCU愈高在「整體成功老化」（β = -0.01）以及「自我觀點及疾病負擔」構面的表現也會愈差（β = -0.04；OR = 0.92）。

結論 本研究指出過多的壓力事件，與較差的成功老化有關，但適當的壓力事件，相較於缺乏壓力事件的刺激，可能在「身體及認知功能」構面會有較好的成功老化表現。

Abstract Background As population ageing quickly, age-related health issues become an important issue around the world. To achieve a good quality of life, it is important to keep older adults ageing “successfully”. However, prior research on successful ageing have been hampered by heterogeneous definitions and assessment approaches. In addition, majority of previous studies mainly focused on physical health, but lacked of psychological related factors. Therefore, this study aimed to explore the relationship between stressful life events and successful ageing in the community-dwelling Taiwanese elderly.

Materials and Methods This is a cross-sectional study. A total of 389 elders (aged 65+) were recruited from the second follow-up (2015-2017) of an ongoing cohort study, of which elders aged 65 were recruited at baseline (2011-2013) from health checkup program of National Taiwan University. Stressful life events were assessed by Social Readjustment Rating Scale (SRRS), which includes 43 life events and a total score of the scale was summed up for each participant. SRRS total score and the number of stressful life events were further categorized into high, moderate and low groups. This study included 14 variables to assess successful ageing and factor analysis was performed to identify the dimensions of successful ageing. Multivariable linear regression and logistic regression models were used to assess associations between stressful life events and dimensions of successful ageing adjusting for important covariates.

Results Three dimensions were identified for successful ageing of Taiwanese Community-dwelling elders, which included “physical & cognitive function”, “individual’s perceptions & diseases burden” and “family & social engagement”. More stressful life events in the past year was associated with poor performance of the “overall successful ageing” (β = -0.40) and the dimensions of “individual’s perceptions & diseases burden” [β = -0.12, odds ratio (OR) = 0.77] and “family & social engagement” (β = -0.05). Elders with less events (< 3 events) in the past year were more likely to have poor performance on the dimension of “physical & cognitive function” (β = -0.23, OR = 0.54) compared with elders with moderate event number (3-6 events). Higher in stressful life events score was associated with poor performance of the “overall successful ageing” (β = -0.01) and the dimension of “individual’s perceptions & diseases burden” (β = -0.04, OR = 0.92).

Conclusion Too many stressful life events maybe associated with poor performance of successful ageing, but moderate life stressful maybe associated with better performance on the dimension of “physical & cognitive function”.