研究背景：
台灣面臨少子女化與人口老化的雙重挑戰，自1993年邁入高齡化社會、2018年轉為高齡社會，預計於2025年進入超高齡社會。據衛生福利部統計，目前老年人口超過400萬，其中12.7%有失能情形，17.5%具衰弱風險。為因應人口老化，世界衛生組織（WHO）提出「健康老化」理念，並推動「高齡整合照護」（Integrated Care of Older People, ICOPE）模式，透過個別化介入提升老年人內在能力與功能。國民健康署於112年啟動「整合性預防及延緩失能新方案研發計畫」，以研發符合在地長者需求之照護方案。本研究以嘉南藥理大學研發之「三動臺南正向心生活」及臺灣方塊踏步運動協會研發之「方塊踏步練武功，健康存摺一把罩」兩項方案為例，探討其對高齡者內在能力之促進成效。

研究方法：
本研究採單一組前後測實驗設計，研究對象為接受ICOPE篩檢後具有認知功能障礙及憂鬱傾向，且能參與日照中心活動之長者，每方案預計招募100人，介入內容皆結合運動與認知雙重任務。資料以IBM SPSS Statistics 22分析，對異常值與缺漏值進行清理與多重差補，以確保資料完整性。描述性統計呈現樣本特性與變項分布，二元及多元類別變項分別使用獨立樣本t檢定與單因子變異數分析。介入效果以配對樣本t檢定或Wilcoxon符號等級檢定進行前後測比較，並以皮爾森相關分析與多元線性迴歸檢視背景變項對介入成效的影響。

研究結果：
「三動臺南正向心生活」結合在地文化與雙重任務訓練，對認知功能（BHT）提升顯著，尤其在原先認知功能較低者最為明顯（p<0.001），但對MMSE、憂鬱情緒及幸福感影響有限，心理健康改善不顯著。「方塊踏步練武功」方案結合方塊踏步運動與認知挑戰，顯著改善認知功能、心理健康及生活品質，並提升社會互動感知，但身體功能提升不明顯，可能因介入頻率與運動強度不足所致。兩方案均展示雙重任務訓練在提升認知與心理健康的正向效益，特別對認知較弱者效果更為明顯。

結論：
兩項方案皆能改善高齡者認知功能，「方塊踏步練武功」亦改善心理健康，顯示在身心整體健康促進與延緩失能方面之潛力。雙重任務訓練結合團體互動，不僅提升功能表現，也促進社會參與。研究成果可作為地方政府高齡健康政策與照護方案設計之參考，建議持續推展並擴大實施範圍，納入更多高齡服務場域，並結合篩檢工具進行成效追蹤與個別化調整。

Taiwan is rapidly aging, with a growing proportion of older adults at risk of frailty and disability. To promote healthy aging, the WHO’s ICOPE framework advocates individualized interventions to maintain intrinsic and functional capacities. This study evaluated two locally developed programs—“Tainan Active and Positive Life” and the “Square-Stepping Exercise Program”—for their effects on cognition, psychological health, and social engagement in older adults.
A single-group pre-post design involved community-dwelling older adults screened by ICOPE as having cognitive impairment and depressive tendencies. Each program delivered 12 weekly 120-minute sessions combining physical exercise with cognitive dual-task training. Paired t-tests or Wilcoxon tests assessed intervention effects, and regression analyses examined demographic influences.
Results showed that “Tainan Active and Positive Life” improved cognitive function, particularly among participants with lower baseline cognition, while “Square-Stepping Exercise” enhanced cognition, psychological well-being, and social interaction. Physical function improvements were limited, likely due to training intensity. Both programs demonstrated the effectiveness of dual-task interventions in supporting cognitive and mental health.
These findings support the use of culturally tailored, integrated interventions to promote healthy aging, functional capacity, and social participation among older adults.

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