背景：台灣將在2026年邁入超高齡社會，高齡照護儼然已成為我國重要健康照護議題。衰弱與高齡、失能習習相關，且被視為是影響生活品質與不良健康預後的重要因子，台灣因此自2017年起推動「預防及延緩失能照護計畫」，將肌力強化運動、生活功能重建訓練、社會參與、口腔保健、膳食營養及認知促進等多元模組方案導入社區，期能改善或預防社區長者衰弱發生。由於計畫推行之課程內容介入相當多元，且為衰弱照護之重要政策，故預防及延緩失能照護計畫仍需更多研究探討其相關成效。
目的：探討預防及延緩失能照護計畫於社區老人衰弱與體適能之成效，並比較不同介入面向組成於改善衰弱及功能性體適能之成效差異。
方法：採次級資料分析(Secondary Data Analysis)，資料收集對象2017-2020年間台南市參與預防延緩失能計畫並有執行老年人功能性體適能之65歲以上長者前後測資料，資料收集內容包含年齡、性別、教育程度、獨居與否、過去一年跌倒情形、課程參與率、過去課程參與經驗、衰弱相關指標(Study of Osteoporotic Fractures, SOF；Kihon checklist, KCL)及老年人功能性體適能測驗結果。資料如僅有後測結果則予以排除。為比較不同介入面向組成於衰弱及體適能之影響，資料收集過程中收集課程表並分析其組成，納入後續資料分析的變項之一。
結果：資料共收集自11個不同的台南市社區單位，包含前測399人、後測344人，資料前、後測流失率為13.8%。結果顯示後測相較於前測在KCL定義之衰弱風險人數有顯著減少(χ2=8.0, p=0.05)，SOF之定義則無明顯差異(χ2=3.0, p=0.182)。在調整人口學變項後，後測相較於前測在SOF總分顯著減少0.07分(β=-0.07, CI=-0.13-0.00, p=0.036)、KCL總分顯著減少0.81分(β=-0.81, CI=-1.14 – -0.48, p<0.001)；根據KCL定義的衰弱風險，在調整人口學變項後，後測相較於前測的勝算比為0.10(Odds ratio=0.10, CI= 0.03-0.36, p<0.001)。老年人功能性體適能之後測在30秒起站(p=0.001)、下肢柔軟度及(p<0.001)兩分鐘踏步(p=0.003)相較於前測有顯著改善；在個別化差異後，後測相較於前測有顯著改善包括30秒起站增加1.25次(β=1.25, CI=0.68- 1.88, p<0.001)、握力增加0.52公斤(β=0.52, CI= 0.03–1.00, p=0.036)、下肢柔軟度增加4.56公分(β=4.56, CI= 2.84 – 6.28, p<0.001)、兩分鐘踏步增加5.44次(β=5.44, CI= 2.48 – 8.39, p<0.001)、2.44公尺步行時間減少0.36秒(β=-0.36, CI= -0.51– -0.20, p<0.001)。課程組成於SOF量表及KCL量表之衰弱評估無顯著差異；不同運動介入時數在握力(β= 0.23, CI=0.04 – 0.41, p=0.016)及步行速度(β= -0.11, CI=-0.18 – -0.04, p<0.001)的表現有顯著影響，每增加1小時的運動介入，握力增加0.23公斤、步行時間減少0.11秒。
結論：整體而言，介入預防及延緩失能照護計畫後，有改善衰弱相關指標及功能性體適能的成效。課程中設計肌力運動強化的介入面向，可顯著改善握力及步行速度的表現。

Frailty is an important geriatric health care issue. The study aimed to investigate the effects of Preventing and Delay Disability Care Program, which is community-based frailty care service, on frailty indexes and functional fitness, and to evaluate different interventional scheme components (strengthening exercises, life function reconstruction training, social participation, oral health care, dietary nutrition, and cognitive promotion) effects on improving frailty and functional fitness. The study was the secondary data analysis design. Total 399 pre-test data and 344 post data were included. Results showed that post compared to pre test, the number of older adults at KCL defined frailty risk (χ2=8.0, p=0.05), results of SOF scores (β=-0.07, CI=-0.13-0.00, p=0.036) and KCL scores was significantly reduced (β=-0.81, CI=-1.14 – -0.48, p<0.001).The functional fitness were significantly improved on lower limb strength (30-Second Chair Stand test, β=1.25, CI=0.68- 1.88, p<0.001), grip strength(β=0.52, CI= 0.03–1.00, p=0.036), lower limb flexibility (Chair Sit-and-Reach, β=4.56, CI= 2.84 – 6.28, p<0.001), aerobic endurance (Step in 2mins, β=5.44, CI= 2.48 – 8.39, p<0.001), and dynamic balance (2.44-meter walk time, β=-0.36, CI= -0.51– -0.20, p<0.001) performances. Generally, the Preventing and Delaying of Disability Care Program has the effect of improving the risk of frailty and functional fitness. The scheme components included muscle strengthening exercises can significantly improve the performance of grip strength, and dynamic balance performances.

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