Summary: | 碩士 === 國立陽明大學 === 物理治療學系暨研究所 === 94 === Abstract
Study background and Purpose:Aging of population is an urgent issue in Taiwan. How to manage the negative effect of aging and to reduce the impact on medical system and social resources are the all-important issues. Successful aging is an Utopian status which represents healthy, robust, positive and active images during aging. In this study, we define successful aging in accordance to quality of life (QoL) and investigate the status of QoL and successful aging related factors in the elderly. Cross-sectional study and retrospective-cohort study are used to collect data, including medical factors, lifestyle variables both before 50 y/o and at present. Furthermore, demographic variables are controlled to analyze if these factors influence the QoL. Affective approach to aging society is anticipated to be formulated in this study after all.
Method:We recruited the elderly for subjects from the sport center (N=80), one rehab clinic (N=122), one institution in Taipei (N=20) and some community in Maoli (N=235) by convenience sampling. WHOQOL-BREF Taiwan version (World Health Organization Quality of Life Assessment) was adopted for data collection. Successful aging was recognized as whose scores in four QoL domains-physical, psychological, social functional and environmental domain-were all above the best 1/4. And demographic variables (gender, age, living status, educational level, income resources and data resources), medical factors (body mass index, hearing, vision, sleeping quality and disease number) and lifestyle factors (smoking, drinking, exercise habit, marriage status, religion, occupation before retirement and social participation at present) before 50 y/o and at present were recorded as independent variables.
Statistics:Descriptive statistics was used to describe the distribution of all variables and QoL. Stepwise multiple regression was used to establish the QoL predictive models. Besides, chi-square and simple logistic was used to compare proportion of successful aging in each variable.
Result:Valid samplings in this study was totally accounted to 457. The age of the subjects was from 65 to 97 y/o (72.24±2.17). Stepwise multiple regressions for QoL showed age, data resources, educational level, hearing, vision, sleep quality, disease number, smoking, exercise habit, occupation and social participation were all significant factors. Among others, data resources, occupation before retirement, current sleep quality, current exercise habit, current social participation were applicable to all four domains in QoL; adjusted R2 was from 0.13-0.48 (p<.0001). Sleeping quality, smoking and exercise habit before 50 y/o even now influenced current QoL. Subjects with higher educational level (OR: 1.80, 1.20-2.69), with stable income resources (OR: 1.83, 1.22-2.73), with good sleep quality before 50 y/o (OR: 2.83, 1.16-6.88), white collar before retirement (OR: 2.17, 1.28-3.66), with good hearing at present (OR: 2.00, 1.19-3.36), with good hearing at present (OR: 2.39, 1.57-3.65), with sleep quality at present (OR: 3.68, 2.21-6.11), without any disease at present (OR: 2.90, 1.70-4.94), with one disease at present (OR: 2.09, 1.32-3.33), with exercise habit at present (OR: 1.99, 1.22-3.25), and with social participation (OR: 1.87, 1.18-2.96) had higher odds ratio in successful aging than compared group.
Conclusion:The elderly who attained successful aging had better QoL than the younger norm whose age ranged from 20-65 y/o. The successful aging demonstrated the elderly could still feel superiorly and positively about themselves, even though disease existed. Since some middle aged modifiable factors such as sleep quality, disease number, smoking and exercise habit had been found to have significant impact on current QoL, positive and active health-promotion behaviors should be taken root in the early years.
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