| Summary: | 碩士 === 亞洲大學 === 健康產業管理學系長期照護組 === 99 === Background: Fall is an important health issue for senior citizens and there is a high association between fall and functional ability. However, there are few longitudinal studies to delineate the nature of the association.
Purpose: The objective of this study was to determine the association between functional ability as indicated by ADL (Activities of Daily Living) and IADL
(Instrumental Activities of Daily Living) and the risk of fall in older Taiwanese.
Method: Data for this analysis were the 2003 and 2007 datasets of “The Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were 2980 subjects who completed both surveys. Logistic regression analysis was employed to determine the
cross-sectional association between ADL and IADL status with the risk of fall in 2003 and 2007 and the ability of 2003 ADL and IADL status to predict the risk fall in 2007 controlled for demographic, lifestyle and health-related variables. SPSS 12.0 was used
for all analyses.
Results: Results showed that in a cross-sectional model that controlled for demographic, lifestyle and health-related variables, IADL is the major factor associated with the current risk of fall and ADL is associated with the risk of fall only
when IADL is not included in the model. Compared to those without IADL impairment, the risk was 1.43, 1.98 and 2.01 times for those who had mild, moderate and severe IADL impairment, whereas mild or moderate ADL impairment was not associated with the risk of fall and severe ADL impairment was associated with a 62% reduction in the risk of fall. Results also showed that IADL impairment was not an
effective predictor of fall four years later. Only mild ADL impairment significantly predicted the risk of fall in four years whereas moderate or severe impairment predicted reduced risk of fall in four years.
Conclusion: Results suggest that any level of IADL impairment and mild ADL impairment predict current or near term risk of fall. However, IADL impairment is not an effective predictor of future risk of fall four years later. Moderate and severe ADL
impairment, on the other hand, is associated with reduced current risk of fall probably because these persons have lost mobility. These results highlight the importance of maintaining functional ability of the elderly. IADL should be the tool of choice for
monitoring the risk of fall of the elderly. These findings should be useful to the public health policy makers in designing effective fall prevention programs.
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