背景：隨著社會經濟的進步與醫療健康照護系統的強化，台灣的人口結構由高生育率、高死亡率轉變為低生育率、低死亡率，使得中老年人之平均餘命逐年增加，因此如何維持中老年人身心健康與獨立生活成為重要公共衛生問題。世界衛生組織（World Health Organization, WHO）於2002年提出活躍老化應包括「健康」、「安全」、「參與」三大面向，使老年人能在整個生命歷程中瞭解自我對於生理、心理、社交潛在需求，並根據他們的需求、能力和渴望，透過社會參與提供他們足夠的安全照護以提昇老年之生活品質。然而，過去有關活躍老化的測量，主要是群體/國家層級的指標，較少專注在個人層級之活躍老化測量。而且，不論在各國或台灣，至今仍缺乏針對個人活躍老化程度與後續的死亡風險關係之探討。

目的：本研究目的為參考台灣活躍老化指標（Taiwan Active Aging Index, TAAI）並從台灣中老年身心社會生活狀況長期追蹤調查」(Taiwan Longitudinal Survey on Aging, TLSA)資料庫挑選出對映項目來分析台灣中老年人活躍老化指數。根據上述之活躍老化指數探討其與後續死亡風險之關係，以及分別探討男性與女性之活躍老化指數與後續死亡風險之關係。

方法：本研究使用衛生福利部國民健康署之台灣中老年身心社會生活狀況長期追蹤調查（Taiwan Longitudinal Survey on Aging, TLSA）資料庫。樣本納入條件為2007年55歲以上中老年人，最終樣本數為3677位。根據台灣活躍老化指標（Taiwan Active Aging Index, TAAI）且從TLSA當中挑選出相對題項，並依照WHO活躍老化三大面向（健康、參與、安全）進行分類，計算出活躍老化指數，最後使用Cox比例風險模型與邏輯式迴歸分析探討2007年台灣中老年人之活躍老化指數與後續死亡風險之關係，追蹤期間為8年至2015年。

結果：調整所有控制變項後，與低分組相比，活躍老化指數為高分組及中分組皆能顯著降低後續死亡風險。在不同面向之指數方面，健康面向指數、參與面向指數高分和中分組皆能顯著減少後續死亡風險，而安全面向指數僅有高分組能顯著降低。不論男性或女性，與低分組相比，活躍老化指數高分組及中分組分別皆能顯著降低後續死亡風險。

結論：活躍老化為一多層面之概念，活躍老化指數的增加可降低後續死亡風險。透過本研究之結果可瞭解台灣中老年人整體活躍老化情形與WHO活躍老化三大面向之個別指數與後續死亡風險之關係。本結果可作為擬定如何降低中老年人之死亡風險或者身心相關政策之參考。

In 2002, the World Health Organization (WHO) proposed that active aging should include "health", "security", and "participation". The purpose of this study was to refer the Taiwan Active Aging Index (TAAI) to select the corresponding items from the Taiwan Longitudinal Survey on Aging (TLSA) and then to calculate the active aging index. Further, the second purpose was to use the above-mentioned active aging index to explore its relationship with subsequent mortality risk of older adults in Taiwan.
We used the Taiwan Longitudinal Survey on Aging (TLSA) database from the Health Promotion Adminitration of the Ministry of Health and Welfare. The final recuirted sample was 3677 who were aged over 55 in 2007. We use Cox proportional hazard model and logistic regression analysis to examine the relationship between the active aging index in 2007 and the subsequent risk of mortality of older adults in Taiwan in 2015.
The results showed that after adjusting all the control variables, the middle-score group and the high-score group of active aging index can significantly reduce subsequent mortality risk, compared with the low-score group. In further analyzing terms of different dimention indexes, both high-score amd middle-score groups of health index and participation index can significantly reduce subsequent mortality risk. However, in safety index, only the high-score group can significantly reduce subsequent mortality risk.
This study concluded that an increase in the active aging index could help reduce the risk of subsequent mortality risk.

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