臺灣博碩士論文加值系統

背景：隨著年齡增長，老年人有較多骨骼肌肌肉減少的情形，尤其是身體虛弱的老人。本研究旨在瞭解社區接受日照中心服務老人罹患肌少症的比率，並進一步探討肌少症指標與營養、身體活動的相關。
方法：本研究採橫斷式研究設計，以高屏地區6家共150 位日照中心所服務的老人為對象。收案期間自2018 年8 月1 日至2018 年12 月31 日。肌少症定義依據2014年亞洲肌少症工作小組所訂定的診斷標準。研究收集資料除了受試者基本特性外，還包括肌少症指標、營養與身體活動。肌少症指標評估是測量四肢肌肉質量、手握力與6 公尺行走速度；營養以身體質量指數(BMI)評估；身體活動以日常生活活動功能量表(ADL)與老年人身體活動量表中文版(PASE-C)評估。
結果: 本研究對象平均年齡在81.92歲(範圍65-100歲)，75歲以上個案將近八成(78%)，男性約73.3%(110位)。超過6成(66.0%)個案有高血壓，44人(29.3%)有糖尿病。體重過輕者(BMI <18.5)有12%，超過5成(54%)個案屬於中或重度依賴(ADL)，且大多數個案傾向靜態或輕度活動。有六成(62.71%)個案有肌少症情形，其中女性有55%，男性有47.27%。經多元回歸分析，女性、骨質疏鬆與低BMI者有較低肌肉量的情形；女性、年齡越大、低BMI者有較低肌力的情形；低ADL及低PASE-C得分者有較低身體功能。
結論：本研究對象肌少症盛行率高達六成，而女性、骨質疏鬆與低BMI、高齡、低ADL及低PASE-C得分是肌少症指標的危險因子。透過本研究結果可提供相關單位健康照護之參考，進而促進老人的健康。

Background: Skeletal muscles decline with age; this occurs commonly in older adults, especially those who are frail. This study investigated the ratio of older adults with sarcopenia among those who lived in long-term care centers, and investigated the relationships of sarcopenia indicators with nutritional status and physical activities.
Methods: This study adopted a cross-sectional study design and selected 150 older adults from six long-term care centers in Kaohsiung and pingtung as the study participants; cases from Aug. 1, 2018 to Dec. 31, 2018 were obtained. This study employed the standard established Asian Working Group for Sarcopenia in 2014 to determine whether the participants were diagnosed with sarcopenia. The case data collected consisted of the participants’ demographic information, sarcopenia indicators, nutritional status, and physical activities, where their sarcopenia indicators included their limb muscle mass, hand grip strength, and 6-meter walking speed; their nutritional status entailed their body mass index (BMI); and their physical activities involved those measured by the activities of daily living (ADL) scale and those measured by the physical activity scale for the elderly, Chinese version (PASE-C).
Results: The 110 participants were aged 65–100 years, and their average age was 81.92; 78% of the participants were aged 75 years, and 73.3% were male; 66%) of the participants were diagnosed with hypertension, and 29.3% (44 participants) with diabetes. A total of 12% of the participants were underweight (BMI < 18.5), and 54% of them were listed as moderately or heavily dependent on their caregivers according to the ADL scores; most of the participants preferred performing static or mild activities. Approximately 62.71% of the participants were diagnosed with sarcopenia, while the prevalence of sarcopenia in female and male were 55% and 47.27%, respectively. A multiple regression analysis showed that women, those with osteoporosis, and those with low BMI had less skeletal muscles; women, those who were older, and those who had low BMI had weaker skeletal muscle strength than the other participants; and those with low ADL and/or PASE-C scores displayed poorer body functions than other participants.
Conclusion: In this study, 60% of the participants had sarcopenia, and the results showed that being female, osteoporosis, low BMI, increased age, low ADL scores, and low PASE-C scores were risk factors of sarcopenia. The study results can serve as references to relevant units when providing health care to older adults, thereby improving their health.

目錄
中文摘要i
英文摘要iii
致謝v
目錄vi
表目錄viii
圖目錄ix
第一章 緒論1
第一節 研究背景與動機1
第二節 研究目的3
第三節 研究問題3
第四節 名詞界定4
第二章 文獻查證8
第一節 肌少症介紹…8
第二節 影響肌少症的社會人口學變項與相關因素13
第三節 營養、身體活動與肌少症的相關研究22
第三章 研究方法27
第一節 研究架構27
第二節 研究對象與研究場所29
第三節 研究工具29
第四節 研究步驟34
第五節 資料處理與統計分析36
第六節 研究倫理考量37
第四章 研究結果38
第一節 社會人口學、肌少症指標、營養狀態、身體活動之現況分
析38
第二節 社會人口學特性與營養狀態(身體質量指數)間關係分析47
第三節 社會人口學特性與身體活動間之關係分析49
第四節 社會人口學特性與肌少症指標間之關係分析52
第五節 身體質量指數、身體活動與肌少症指標間之關係分析55
第六節 肌少症指標之重要預測因子56
第五章 討論59
第一節 日照中心老人肌少症盛行率之討論59
第二節 肌少症指標與相關因子之討論60
第六章 結論、建議與限制63
第一節 結論63
第二節 建議64
第三節 限制66
參考文獻67
附錄一 個人基本屬性表84
附錄二 日常生活活動功能量表(ADL)85
附錄三 老年人身體活動量表中文版(PASE-C)86
附錄四 PASE計分及加權指數對照表88
附錄五 身體質量指數(BMI)89
附錄六 人體試驗倫理委員會同意證明書90
附錄七 老年人身體活動量表中文版(PASE-C)授權書91
附錄八 肌少症測量圖92

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