2026-11-092026-11-09https://scholars.csmu.edu.tw/handle/123456789/38588Once older adults develop mild difficulty (mobility disability), they are at twice the risk of developing problems in instrumental activities of daily living (becoming moderately disabled) and activities of daily living (becoming severely disabled) compared to those without such difficulty. Severe physical disability in older adults has been shown to be a significant predictor for nursing home admission and mortality and an indicator of health status or quality of life for the elderly. Most importantly, such disability can be reduced and prevented. For the purposes of early detection and intervention, clinicians should give due attention to mobility disability, as this is the first to decline and is therefore a more sensitive indicator of impending physical disability. Thus, a psychometrically sound screening tool that could also guide intervention is required. A self-reported measure of task difficulty and modification in mobility function can identify older adults at pre-clinical stages of physical disability. In addition to self-reported measures, physical performance tests, when employed to objectively measure physical performance in older adults, indicate physical function decline before it is perceived by the individual tested. Thus, identifying those tests (both self-reported and performance-based measures) among the most commonly used performance tests that best discriminate and predict mobility disability, so that they can be recommended for use in community screening, is the first step in preventing physical disability in older adults. First, a screening tool needs to be able both to discriminate older adults with and without mobility disability and to predict the development of physical disability in the future. In this proposal, we plan to examine 5 performance tests that could be used in community screening and determine the one(s) with the best discriminate and predictive validity. Second, the screening program should target the age group with the highest prevalence of mobility disability in order to determine the age group at which the physical disability screening program should be targeted. Lastly, the availability of reference values for each of these performance measures would be of value to both clinicians and researchers for the accurate interpretation of physical performance in older adults based on test scores. The purposes of this study are as follows: In the first year: (1) to report the performance test results for older adults at different physical disability status (descriptive statistics); (2) to report the prevalence of different physical disability statuses in each age group.In the second year: (1) to report the incidence rate for mobility disability in each age-gender group; In the third year: (1) to report the discriminate validity, predictive validity, and cutoff values of the five performance tests for older adults who are able at baseline assessment and subsequently develop pre-clinical disability or mild disability; (2) to report the age group that has the highest prevalence of mobility disability. A stratified randomization sampling strategy will be used to select our sample from older adults aged 60+years living in the community in Taichung City. We plan to recruit 200 participants for each gender (age groups: 60-64, 65-69, 70-74, 75-79) and 100 for each gender (age: 80-84), for a total of 1,800 subjects. Only those who are “able” at baseline assessment will be followed up to determine their physical disability status, either for 3 years or until they develop mobility disability, whichever comes first. Two raters will be responsible for data collection. One of them will be in charge of basic information, physical disability status assessments, and all interview assessments, and the other, who will be blinded to the older adult’s physical disability status, will be responsible only for the administration of all the performance tests.老人發生輕度(活動功能)身體失能(mobility disability)未來發展成為中度及重度身體 失能的機會是無身體失能者的二倍。重度身體失能不僅是預測是否會住進護理之家、 死亡率、及健康狀況的危險因子，對老人的身、心健康更是一大威脅，同時也造成國 家醫療預算上的一大負擔。所以從預防醫學的觀點，如何有效維持老人體能，始免於 發生重度失能，將有助於維持老人的身、心健康及減輕國家醫療預算的重擔。 以詢問方式也可以確定臨床前期的身體失能(pre-clinical physical disability)，然而這 不能引導後續的介入計劃。許多下肢功能測試都與老人活動功能相關，且功能表現測 試(performance test)比詢問(self-reported measure)方式更能發現早期衰退的狀況，而且還 能指引後續介入計劃的規劃。所以找出能夠預測未來發生活動失能(mobility disability) 的身體功能測試(physical performance tests)，有助於醫療照護者於社區篩檢時，有效地 找出未來將發生活動失能的高危險群，這是預防老人失能的第一步。 首先，篩檢的工具也必須具備足夠的鑑別能力及預測能力。本計劃預計針對五項功 能測試以及臨床前期的身體失能進行研究，以便得知最適合用於社區篩檢的工具。 其次，篩檢計畫必需針對高危險的群體進行，本計劃預計追蹤五個年齡層的老人三 年，以便報告，各年齡層發生活動失能的發生率，了解發生率高的年齡層將有助於規 劃社區篩檢的主要對象。 最後，功能測試常使用於評估老人各項與活動相關的功能，如肌力、一般活動能力、 步行速度等，而國內老人在這些測試的標準值或重要參考值仍未知。 故本研究目的有：第一年：(1)報告各階段身體失能(無身體失能、輕、中、重度失 能)老人在五項身體功能之表現；(2)報告各年齡層發生各階段身體失能的盛行率；第二 年：(1)報告各年齡性別組中，無失能老人發生輕度失能的發生率；第三年：(1)報告五 項身體功能表現及臨床前期的身體失能在區辨及預測老人由「無身體失能」發展至「輕 度失能」之區辨效度、預測效度、及切割點；(2)報告發生「輕度失能」危險性最高的 年齡層以及身體功能衰退發生最巨幅的年齡層，以便作為預防計劃規劃之依據。 本研究預計針對住在台中市社區中年滿60 歲以上的老人，以分層隨機抽樣方式取 樣，分五個年齡層(60-64 歲、65-69 歲、70-74 歲、75-79 歲、80-84 歲)，預計60-79 歲 各年齡層男女各收200 人，80-84 歲男女各收100 人，故總收案數預計為1800 人。僅 第一年評估為「無失能」者，將繼續追蹤三年或到老人發生臨床前期失能或輕度失能 為止。有二位測試者一同進行資料收集。其中一人負責基本資料、身體失能評估等面 談方式的資料收集。另一人不知道老人身體失能的狀況，僅負責身體功能測試的執行。Project