成功老化之生命週期分析

Abstract

[[abstract]]研究背景：成功老化為近年來全球老年健康的重要議題，過去研究以測量老年人成功老化的現況及其危險因子與保護因子，然而對於身體、心理、社會健康層面已經失能或不成功者，其危險因子的累積弱勢或負面影響早以難做改變，而應該採取生命週期觀點及早進行預防和健康促進。 研究目的：本計畫目的為探討生命週期對成功老化的影響，研究問題包括：1.生命週期與世代比較：將分析比較台灣中年人與老年人不同世代的成功老化情形，探討生命週期風險對成功老化的可能影響。2.成功老化軌跡：成功老化各指標之健康軌跡，以及相關因素對不同軌跡的成功老化變化之影響大小。3.身體失能與慢性病老人之成功老化分析與保護因子：對於身體面向失能者或患慢性病老人與完全成功老化老人在其他面向成功老化的情形之差異，以及探討保護其心理與社會面向健康和主觀幸福感的因素為何。4.年齡整合與成功老化：探討年齡整合是否有助於成功老化。 研究方法：本計畫定義成功老化指標包括身體面向(日常生活活動功能與工 具性日常生活活動功能正常)、心理面向(認知功能正常與無憂鬱症狀)、社會面向(良好社會支持與投入生產力活動)、以及主觀幸福感。資料來源為國民健康局「老人保健與生活調查」1989-1999 年資料(若2003 年資料已開放亦將申請)，該資料為具全台灣老人代表性之面訪調查之長期追蹤資料，1989 年樣本為60 歲以上老年世代樣本，於1996年並加入50-66 歲中年人世代樣本。分析方法預定將以SPSS/PC 或SAS/PC 等進行分析，統計方法採用長期追蹤資料與多變項分析，包括多類別邏輯式迴歸分析、重覆測量混合效果模式、概化估計方程等。 預期研究成果：預測未來老年世代(即目前的中年世代)的成功老化情形；了解生命週期中成功老化之危險因子作用時間與影響大小；了解成功老化者之保護因子，以及身體失能者之其他面向成功老化保護因子，以提供未來研究外在資源介入效果以及健康促進政策參考。 Successful aging has been the emergent issue of elder health in the world. Past research has found the successful aging status and related risk factors or protective factors. However, for those elderly who have failed in physical, psychological, or social dimension in successful aging, the cumulative disadvantage of risk factors is too late to intervene or modify. A life course perspective to analyze the successful aging in order to disease prevention and health promotion is necessary. The purpose of this project is to analyze the successful aging across life course. The research questions include: 1. Life course and cohort comparison:We will analyze the difference of successful aging between the middle-age cohorts and older cohorts, and the effect of risks across life course to successful aging. 2. Successful aging trajectories:We will analyze the trajectory of each successful aging indicator, and analyze the effect of related factors to different trajectory people. 3. Protective factors for disabled and sick elderly: For those elderly who were disabled in physical dimension successful aging or having chronic diseases, we will compare their difference with successful aging elderly in other indicators, and to explore the protective factors to psychological health, social health or subjective wellbeing. 4. Age integration and successful aging:We will explore if age integration helps in successful aging. This research project defines successful aging measures include physical dimension (normal function in activities of daily living (ADL) and instrumental activities of daily living (IADL)), psychological dimension (normal cognitive function and absence of depressive symptoms), social dimension (good social support and engagement with productive activities), and subjective wellbeing as well. Data come from “Survey of Health and Living Status of the Elderly in Taiwan”, 1989-1999, a national representative samples executed by Population and Health Survey Center, Bureau of Health Promotion, Department of Health, R.O.C. (We will apply the wave in 2003 if it is open). In 1989 the samples were the older cohorts who were aged 60 or more, and in 1996 the middle-age cohorts (aged 50-66) samples were added in the panel too. The analysis will be conducted by SPSS/PC or SAS/PC. The statistics methods include descriptive statistics, longitudinal data analysis and multivariable analysis, like multi-nominal logistics regression, repeated measure mixed effect model, generalized estimated equation, etc. This project is expected to predict the successful aging of the future elderly (current middle-age cohorts), to realize the effect of risk factors to successful aging across life course, to explore the protective factors of successful aging in other dimensions for physically disabled elderly, therefore to offer the suggestions and implications for future studies and intervention in health promotion.