[[alternative]]A Study of Physical Activity, Frailty Status and Health Related Quality of Life among Community-Dwelling Older Adults

[[abstract]]研究背景：擁有健康的生活品質是老年生活的重要目標，相關文獻指出社區老年人的健康相關生活品質會因身體活動功能的表現越佳而提升，但健康相關生活品質卻會因為衰弱而有負向影響，目前對此方向研究探究較少。研究目的：本研究旨在探討社區老年人之身體活動、衰弱狀態與健康相關生活品質三者間的相關性，以及探討影響研究對象健康相關生活品質的重要預測因素。研究方法：採橫斷式設計，以方便取樣方式，選樣自臺北市士林、北投區之社區關懷據點共150位長者，研究工具包含基本資料、老年人身體活動量表、流行病學研究中心憂鬱量表與12項簡式健康調查表，及老年人體適能測驗和握力測量收集資料，並使用SPSS 22.0統計軟體進行獨立t檢定、卡方檢定、變異數分析、皮爾森相關係數和階層迴歸分析結果。研究結果：(1)研究對象平均年齡為76.09±6.53歲，上肢體能表現偏弱，且以握力下降之衰弱問題較常見，生理健康之生活品質低於心理，且整體健康狀況明顯不佳。(2)年齡越高、男性、離婚和喪偶、低教育程度、與兒女親友同住、晚輩提供經濟來源、使用菸酒、跌倒越多次、慢性病數量越多或身體質量指數偏高之特質都顯著對身體活動、衰弱狀態和健康相關生活品質造成影響。(3)身體活動功能表現越佳或衰弱狀態越嚴重都會影響健康相關生活品質。(4)控制人口學特性變項後，上肢肌力/肌耐力和衰弱前期者為影響健康相關生活品質之重要預測因素。結論與建議：本研究發現此研究對象的健康相關生活品質會因上肢功能不佳與邁入衰弱初期而受到影響。面對社區老年人除了給予整體健康照護指導及關注，社區健康促進活動更應針對老年人身體功能著手，提供老年衰弱資訊並促使積極參與社區活動，增進社區老年人對自身體適能與生活品質的重視。[[abstract]]Background:Having a healthy quality of life (QoL) is an important life goal for older adults. Prior studies indicated that the health-related QoL in community-dwelling older adults improved due to the better performances of physical activities. However, age-related frailty had a negative impact on the health-related QoL. At present, there were little studies on discussing this association.Objective:This study aimed to explore the associations among physical activity, age-related frailty, and health-related QoL for community-dwelling older adults. Several important predictors regarding health-related QoL were studied.Methods:In a cross-sectional study, we enrolled 150 older adults by convenience sampling from community care sites in Shilin and Beitou districts of Taipei City. The baseline characteristics, the Physical Activity Scale for the Elderly (PASE), the Center for Epidemiologic Studies Depression Scale (CES-D), and the 12-Item Short Form Health Survey (SF-12) were collected. The Senior Fitness Test (SFT) and hand-grip strength were also performed. Student-t test, Chi-square test, analysis of variance (ANOVA), Pearson correlation coefficient, andhierarchical regressionwere applied to analyze the statistical results by using SPSS statistical software, version 22.0.Results:(1) The average age of the study participants was 76.09±6.53 years. The physical performance of the upper limb was relatively weak. A decline in hand-grip strength was a common problem for older adults. The scores of physical health-related QoL were lower than the scores of mental health-related QoL. The overall health status for older adults in this community was significantly poor. (2) Older age, male gender, status of divorce and widowhood, lower education, living with children and relatives, with financial support by juniors, tobacco or alcohol use, higher falling number, more chronic diseases, or higher body mass index were predictors that had significant impact on physical activity, frailty status, and health-related QoL. (3) The health-related QoL was significantly affected by the performance of physical activity or status of frailty. (4) After adjusting for demographic variables, muscle strength/endurance and pre-frail period were important predictors of health-related QoL.Conclusions and Suggestions:This study found that the health-related QoL for the study participants was affected by upper-limb dysfunction and pre-frail period. In addition to giving comprehensive health care guidance and attention, the community health promotion activities shall focus on older adults’ physical functions. Also, providing information of age-related frailty and promotion of active participation in community activities may increase the attention of physical fitness and QoL for those community-living older adults