葉志嶸YEH,CHIH-JUNG柯品妤KO,PING-YUKO公共衛生學系碩士班2026-03-172025-07-3120242024-06-28https://handle.ncl.edu.tw/11296/tpz9yghttps://scholars.csmu.edu.tw/handle/123456789/5726目的 探討營養狀況良好、有營養不良風險及營養不良的老年人與憂鬱症狀及認知功能的橫斷面及縱貫面之影響，以提升老年人在營養、憂鬱等照護方面，並且可以更加重視和滿足老年人無論是生理或是心理的需求，提升整體的健康狀態。方法 以國民健康署「台灣中年身心社會狀況長期追蹤調查」之1999、2003、2007年三波進行調查，以1999年營養狀況(MNA)作為基線，其各年憂鬱(CES-D10)和認知功能(SPMSQ)皆有資料才納入分析，使用複邏輯式迴歸分析(multiple logistic regression)探討營養狀況在與各年憂鬱狀況及認知功能狀況之相關性；並進行性別、年齡及居住狀況之分層分析。結果 在1999年的橫斷面研究中，顯示各種程度的營養狀況與憂鬱症狀具有顯著相關性(OR=4.2, 95%CI：3.4-5.1；OR=12.3, 95%CI：8.6-17.6)。分層分析進一步指出，男性(OR=19.2)、64歲以下(OR=13.3)和獨居者(OR=22.2)的憂鬱風險明顯高於對照組。 在2003年的四年後追蹤研究中，各種程度的營養狀況仍然與憂鬱症狀有相關(OR=1.6, 95%CI：1.2-2.3；OR=2.0, 95%CI：1.1-3.4)，且只有營養不良與認知功能障礙具有顯著相關性(OR=2.0, 95%CI：1.1-3.7)。分層分析顯示，有營養不良風險的女性(OR=1.7)和非獨居者(OR=1.6)憂鬱風險顯著相關；營養不良的75歲以上者(OR=3.1)憂鬱風險亦顯著相關。有營養不良風險的男性(OR=2.3)、營養不良的女性(OR=2.2)、75歲以上者(OR=2.4)及非獨居的老年人(OR=1.9)認知功能障礙風險顯著相關。 在2007年的八年後追蹤研究中，只有營養不良的男性(OR=4.3)和非獨居者(OR=2.6)在認知功能障礙顯示出顯著的相關性。結論 營養不良與憂鬱症狀在橫斷面之間存在顯著的關聯，也發現對認知功能具有顯著的負面影響。無論是憂鬱症狀還是認知功能的變化，營養狀況均扮演著重要角色，這強調了老年人營養的重要性，提示在公共健康政策中應更多地考慮營養因素，以改善老年人群的整體健康狀況，包括心理和認知健康。Objectives Examining the cross-sectional and longitudinal impact of nutritional status—whether normal nutritional status, at risk of malnutrition, or malnourished—on depression symptoms and cognitive function in the elderly, aims to enhance care for older adults in nutrition and mental health, addressing their physiological and psychological needs to improve overall health outcomes.Methods Data were collected from the Health Promotion Administration 's " Taiwan Longitudinal Study on Aging " in 1999, 2003, and 2007. The 1999 nutritional status (MNA) was used as the baseline. Only participants with data on depressive symptoms (CES-D10) and cognitive function (SPMSQ) in all three waves were included in the analysis. Multiple logistic regression was used to investigate the association between nutritional status and depressive symptoms and cognitive function in each year. Stratified analyses by gender, age, and living status were also conducted.Results In the 1999 cross-sectional study, it was shown that various degrees of nutritional status are significantly associated with depressive symptoms (OR=4.2, 95% CI: 3.4-5.1; OR=12.3, 95% CI: 8.6-17.6). Stratified analysis further indicated that the risk of depression is significantly higher in males (OR=19.2), individuals under 64 years old (OR=13.3), and those living alone (OR=22.2) compared to the control group. In the 2003 four-year follow-up study, various degrees of nutritional status remained associated with depressive symptoms (OR=1.6, 95% CI: 1.2-2.3; OR=2.0, 95% CI: 1.1-3.4), and only malnutrition was significantly associated with cognitive impairment (OR=2.0, 95% CI: 1.1-3.7). Stratified analysis indicated that the risk of depression was significantly associated with females at risk of malnutrition (OR=1.7) and those not living alone (OR=1.6). The risk of depression was also significantly associated with individuals over 75 years old who were malnourished (OR=3.1). The risk of cognitive impairment was significantly associated with males at risk of malnutrition (OR=2.3), malnourished females (OR=2.2), individuals over 75 years old (OR=2.4), and elderly individuals not living alone (OR=1.9). In the 2007 eight-year follow-up study, only malnourished males (OR=4.3) and those not living alone (OR=2.6) showed a significant association with cognitive impairment.Conclusions There is a significant association between malnutrition and depressive symptoms in the cross-sectional analysis, and malnutrition also has a significant negative impact on cognitive function. Nutritional status plays an important role in both depressive symptoms and cognitive function changes. This highlights the importance of nutritional for the elderly, suggesting that public health policies should give more consideration to nutritional factors to improve the overall health status of the elderly population, including both psychological and cognitive health.老人營養不良憂鬱認知功能障礙ElderlyMalnutritionDepressionCognitive function impairmentthesis