顏啟華李孟智顧明祥Ming-Hsiang Ku醫學研究所2026-10-289999-12-312013https://handle.ncl.edu.tw/11296/atqd53https://scholars.csmu.edu.tw/handle/123456789/35867前言： 伴隨人口高齡化，許多疾病及相關症狀對老年人健康造成危害，糞便失禁與老年憂鬱便包含其中。本研究藉國民健康局「台灣中老年人身心社會狀況長期追蹤調查」2003-2007年資料，探討台灣老年人糞便失禁盛行率及糞便失禁是否為憂鬱症狀的危險因子。方法：本研究根據「台灣中老年人身心社會狀況長期追蹤調查」當中台灣地區(不包括山地鄉) 於2003年底年滿60歲及以上社區老年人3446位，統計該群體糞便失禁盛行率；扣除非本人回答問卷及已知有憂鬱症狀者共得2,324人。選定其中所有患有糞便失禁症狀的88位對象，再透過隨機不可置換法抽樣，耦配4位同年齡（±1歲）但不具糞便失禁老人，共得440位研究對象。追蹤至2007年，採用簡式之流行病學研究中心憂鬱量表（10-item Center for Epidemiologic Studies Depression Scale, CES-D 10)篩出新發生的老年憂鬱症狀個案，估算患有糞便失禁老人比起無罹患者是否有較高的憂鬱症狀發生率，並藉由條件式邏輯斯迴歸分析辨識糞便失禁相較於個人特質、社會精神逆境、功能退化、慢性疾病與自覺健康、尿失禁及健康行為等上述已知造成憂鬱的因子外，是否為作為老人憂鬱症狀的危險因子。所有的統計分析均採用雙尾檢定，均以p＜0.05當作統計上有意義之參考。結果：台灣居住於社區的老年人糞便失禁症狀盛行率為6.3％；男性6.2％、女性6.4％。針對2003年研究的440位老年人進行為期4年追蹤，發現其中有61人 (13.9%)死亡、1人 (0.2%)出國及57人 (13.0%)無法完成後續訪查或無法評估。故截至2007年止僅餘321人；其中67人被發現有新發生憂鬱症狀，佔20.1％，當中糞便失禁者33.3％、無糞便失禁者17.8％，具有顯著差異。糞便失禁老人與無糞便失禁老人的憂鬱症狀發生率分別為每年6.5%及3.3%。以條件式邏輯斯迴歸發現老年人若罹有糞便失禁也較無糞便失禁者更容易有老年憂鬱症狀(OR=4.508，95％ CI=2.275-8.934)；若對經濟狀況不滿意也較對於經濟狀況滿意者更容易產生老年憂鬱症狀(OR=1.950，95％ CI=1.018-3.736)。結論：台灣居住於社區的老年人罹患糞便失禁症狀盛行率為6.3％；男性6.2％、女性6.4％；老人若患有糞便失禁，會比沒有失禁症狀同齡者較易出現憂鬱症狀。Objective:As the population ages, the conditions and diseases that harm elderly health increase in prevalence, including fecal incontinence and depression. This study aims to explore the prevalence of fecal incontinence among elderly in Taiwan, and whether it is a risk factor of geriatric depressive symptoms.Methods:Data is derived from a longitudinal cohort of “Survey of Health and Living Status of the Elderly in Taiwan”, during a 4-year period of 2003 to 2007. This study included all subjects aged ≥ 60 years at year 2003, living within community, and calculated their fecal incontinence prevalence. Any subjects that didn’t take the survey personally or had depressive symptoms at baseline were excluded, resulting in 2,324 eligible candidates. All 88 elderly with fecal incontinence were included for study, and age matched (±1 year) with 4 elderly without fecal incontinence. Risk profile for depression was measured, including relevant anthropometrics, psychosocial adversity, functional decline, chronic disease, self-perceived health status, urinary incontinence and health habits. The 10-item Center for Epidemiologic Studies Depression Scale (CES-D 10) was used at 2007 to detect new incident depressive status, and the incidence rate of depressive symptoms in both fecal continent and incontinent elderly were calculated. Through conditional logistic regression, fecal incontinence was evaluated against the fore mentioned depression risk factors. All statistical analyses were two-tailed, and p<0.05 was considered significant.Results:Prevalence of fecal incontinence within community elderly in Taiwan is 6.3%, of which 6.2% men and 6.4% women were incontinent. Of the 440 matched subjects at 2003, 61(13.9%) had died, 1(0.2%) had emigrated and 57 (13.0%) were unable to complete the follow-up at 2007. Sixty seven elderly (20.1%) had new onset depressive symptoms, of which the fecal incontinent group had significantly higher incidence (33.3%) compared to the continent group (17.8%). The annual incidence rate of depressive symptoms in the fecal incontinent elderly was 6.5%, almost the double of the 3.3% annual incidence among the fecal continent elderly. Conditional logistic regression showed that fecal incontinence (OR = 4.508, 95% CI = 2.275 - 8.934) and unsatisfactory financial status (OR = 1.950, 95% CI = 1.018 - 3.736) were both independent risk factors for geriatric depressive symptoms. Conclusions:Prevalence of fecal incontinence among Taiwan elderly is 6.3%, with equal sex distribution. Fecal incontinence is a risk factor for depressive symptoms in the elderly.thesis