[[alternative]]Correlation Between Physiological Indicators, Psychological Resilience, Sensory Function, Sleep Quality, And Cognitive Status In Pre-frailty Older People.

[[abstract]]背景：隨著高齡的世代來臨，潛藏在社區中衰弱前期合併有認知障礙的長者，其發生率可能逐年增加。衰弱前期與認知功能異常之間的交互危險因子，因初期不易用問卷偵測其認知功能，目前亦較少有相關研究進行調查。目的：本研究目的包括1.了解衰弱前期長者之基本屬性、生理指標、心理韌性、感官功能、睡眠品質及認知狀態之現況。2.探討衰弱前期長者之基本屬性、生理指標、心理韌性、感官功能、睡眠品質與認知狀態之相關性。3.探討衰弱前期長者之基本屬性、生理指標、心理韌性、感官功能、睡眠品質對認知程度之預測性。方法：本研究為橫斷性研究，以立意取樣方式，共167位衰弱前期長者成為研究樣本，進行生理指標、心理韌性、感官功能、睡眠品質與認知狀態的資料收集。使用SPSS 22軟體進行資料編碼與建檔，以描述性統計、獨立樣本t檢定、卡方檢定及羅吉斯迴歸，進行資料統計及分析。結果：本研究共收案167人，研究結果顯示，年齡較高(χ²=20.540，p < .05)、未具有使用手機傳送訊息能力的長者(χ²=22.932，p < .05)、慢性病數量多(χ²=6.196，p < .05)、 工具性日常生活活動功能差(χ²=3.943，p < .05)，心理韌性低分者(χ²=16.867，p < .05)、有憂鬱傾向 (χ² =24.352，p < .05)，以及睡眠品質不佳(χ²=7.755，p < . 01)長者其認知狀態越差。社區衰弱前期長者未具有使用手機傳送訊息能力(β=-.981，p < .05)以及有憂鬱傾向(β=1.432，p < .05)，會有較差的認知狀態，整體預測值達73.1%。 結論：研究顯示，衰弱前期長者其生理指標、心理韌性、感官功能及睡眠品質會影響其認知狀態。同時，未具有使用手機傳送訊息能力及有憂鬱傾向的長者，為預測衰弱前期長者在認知功能狀態之重要因子。 護理運用:根據研究發現，應加強資源投入於推動長者積極增加手機使用。規劃手機應用教學及網路使用課程，能讓衰弱前期長者更能具備搜尋健康相關資訊的能力，並從中獲得關懷的訊息，進而情感加溫，改善心理與情緒狀態，對於未來將能有適切的延緩失能及提升生活品質。[[abstract]]Background: The advent of population aging can increase the latent incidence of prefrailty comorbid with cognitive impairment among community-dwelling older adults. Initially, it is difficult to use questionnaires to detect its cognitive function, and few studies investigated the interaction between risk factors of prefrailty and cognitive impairment.Objective: The objective of this study was threefold: (1) to determine the current demographic attributes, physiological indices, psychological resilience, sensory functions, sleep quality, and cognitive status of older adults with prefrailty; (2) to establish the correlations between the demographic attributes, physiological indices, psychological resilience, sensory functions, sleep quality, and cognitive status of older adults with prefrailty; and (3) to determine the predictive powers of demographic attributes, physiological indices, psychological resilience, sensory functions, and sleep quality on the cognitive status of older adults with prefrailty.Methodology: This study was a cross-sectional study that applied purposive sampling for the collection of data on physiological indices, total of 167 older adults became the research sample, psychological resilience, sensory functions, sleep quality, and cognitive status. SPSS 22 was employed for data encoding and archiving. Descriptive statistics, independent-samples t-test, chi-square test, and logistic regression were used for data processing and analysis.Results: A total of 167 participants were included. The results were as follows: being advanced in age (χ²= 20.540, p < .05), not knowing how to share images or articles on smartphones (χ²= 22.932, p < .05), and having a relatively large number of chronic diseases (χ²= 6.196, p < .05) were significantly correlated with cognitive status. Among physiological indices, poor performance in instrumental activities of daily living (IADL; χ²=3.943, p < .05), low psychological resilience score (χ²= 16.867, p < .05), high depression tendency (χ²= 24.352, p < .05), and poor sleep quality (χ²= 7.755, p < .05) differed significantly with the level of cognitive status. In terms of predictors, a higher risk of cognitive impairment was observed among community-dwelling older adults with prefrailty who did not know how to share images or articles on smartphones (β = -.981, p < .05) and exhibited a high level of depression tendency (β = 1.432, p < .05). The overall predictive power was 73.1%.Conclusion: For older adults with prefrailty, age, sharing information on smartphone, number of chronic diseases, poor performance in instrumental activities of daily living, depression, low psychological resilience, and poor sleep quality were all found to differ significantly with their cognitive status. Older adults who did not know how to share images or articles on smartphones and exhibited high depression tendency faced a higher risk of cognitive impairment.Implication in nursing care: Teaching the use of smartphones and the Internet can familiarize older adults with smartphones, thereby allowing them to receive more social and emotional support. This can be expected to improve their mental and psychological state, making them healthier and having more interpersonal interactions. Moreover, the development of simple scales will allow older adults with prefrailty to perform self-assessment at home and discover cognitive impairment in advance, which will be conducive for subsequent provision of nursing care. These suggestions can help older adults and their families in delaying the development of disabilities and improving their quality of life through care.Keywords: prefrailty, physiological index, psychological resilience, sensory function, sleep quality, cognitive statu