台灣老人肥胖及非肥胖族群其自覺健康狀況及生活方式之差異：民國九十一年國民健康促進知識、態度與行為調查結果

Objective: This cross-sectional study was conducted to explore the difference of perceived health status and life styles among elderly population of obese group and not-obese group in Taiwan. Materials and Methods: This study utilized cross-sectional data from the Bureau of Health Promotion, Department of Health in Taiwan. The information was collected during the National Survey on Health Promotion Knowledge, Attitude, and Practice (HP-KAP Survey) in 2002. This population-based cross-sectional survey was conducted by face-to-face interview of 26,755 Taiwanese, and had a response rate of 81.9%. The participants (596 obese and 3343 non-obese) in our study were aged 65 and over. Means, percentages, Chi-Square test, Spearman rank-order correlation and Logistic regression were used for data analysis. Results: The prevalence of obesity among Taiwanese elderly was 12.8% in men and 17.7% in women. When using Spearman rank-order method to analyze the obese group, prominent correlations were found between the current perceived health status and chronic diseases, such as hypertension, hyperlipidemia, heart disease, stroke, diabetes mellitus, osteoporosis, and renal disease. Similar results were seen within the non-obese group. When using Logistic regression, a correlation was identified in the elderly population in which those being older(OR= 1.03, 95% CI: 1.01- 1.04), non-exercisers (OR= 2.23, 95% CI: 1.92- 2.58), having more chronic diseases(OR= 1.62, 95% CI: 1.53- 1.72), living independently(OR= 1.27, 95% CI: 1.01- 1.60), visiting Western clinic(OR= 2.12, 95% CI: 1.81- 2.50), visiting Chinese clinic(OR= 1.74, 95% CI: 1.36- 2.23) and visiting alternative medicine clinic(OR= 1.39, 95% CI: 1.02- 1.88) in the past 1 month usually reported a poorer self-perceived health status. Significant correlation of age, BMI, hypertension, heart disease, diabetes mellitus, and the habit of smoking with obesity was found using Spearman rank-order correlation. After adjusting for age, gender, and years of formal education, logistic regression showed the risk of obesity was higher in elderly betel nut chewers than non-chewers(OR= 1.63, 95% CI: 1.01- 2.61) and elderly ex-smokers of cigarettes than non-smokers (OR = 1.46, 95% CI: 1.07 - 1.97). Conclusions: Perceived health status among elderly population is correlated with the presence of chronic diseases as well as regular exercise. Therefore, our health care systems should be fully aware of these issues and consequently provide better control or care for those elderly patients with chronic diseases and simultaneously encourage them to participate more in regular exercise. More attention to the relationship between betel nut chewing and obesity in the elderly should be paid by our health care system to provide better care for this subgroup of obese elderly.