高齡者之老化信念、老化態度與活躍老化的心理建構與異質性分析及其與執行功能之關聯

Abstract

隨著全球快速高齡化，各國在健康、社會與經濟層面面臨重大挑戰，「促進高齡者健康與生活品質」已成二十一世紀的重要課題。老化歷程受個體心理與社會環境交互影響。為深入理解相關心理與行為因素，本研究透過三項子研究，系統探討高齡者老化信念、老化態度、活躍老化與執行功能之關係。本研究首先聚焦於老化信念與態度對活躍老化的影響，認為此二者作為高齡者因應老化的核心心理建構，不僅影響其對老化的接受程度，也可能影響其參與行為與健康決策。活躍老化則反映高齡者在生活中的主動參與程度，執行功能則為其認知能力的重要指標，對高齡者之自主性與生活品質具深遠影響。研究一採用橫斷式問卷調查設計，蒐集臺灣地區552位高齡者之背景與老化信念、老化態度、活躍老化三份量表資料，並透過結構方程模式檢驗各變項之關聯。結果顯示，正向老化信念可透過強化正向老化態度，進一步提升高齡者活躍老化程度，支持老化態度在其中具中介角色。研究二運用潛在剖面分析技術，根據高齡者在老化信念與態度上的反應模式，歸納出「逃避型」、「樂觀型」、「成長型」與「矛盾型」四種潛在剖面，顯示高齡者在老化心理建構上具有明顯的異質性。進一步以多項式羅吉斯迴歸分析社會人口學變項之預測效果，發現性別、教育程度、自覺健康與經濟狀況以及居住地區皆為顯著預測因子。研究三以執行功能測驗系統之軌跡標示測驗、更新能力測驗及西蒙轉換作業三項測驗來評估高齡者的抑制、認知轉換、工作記憶廣度與更新等核心執行功能表現。分析結果發現，老化信念、老化態度與活躍老化與執行功能之間並無顯著關聯，顯示此類心理變項對認知功能之影響仍待進一步釐清。綜整三項研究結果，顯示老化態度在老化信念與活躍老化之間具中介功能，凸顯其於高齡者行為參與歷程中的關鍵作用；同時亦確認老化信念與態度為可區辨且具有潛在異質性的心理構念。然而，心理變項與執行功能間的關係尚未獲得支持，可能受限於測量方法或樣本特性的影響。整體而言，本研究有助於深化對高齡心理歷程的理解，並為未來健康老化政策與心理介入策略提供理論基礎與應用參考。With the rapid global population aging, countries worldwide are increasingly facing health, social, and economic challenges. Promoting the health and quality of life among older adults has therefore become a critical issue in the 21st century. Aging, as a natural and irreversible life process, is shaped by the dynamic interplay between individuals' internal psychological mechanisms and external social environments. To deepen the understanding of key psychological and behavioral variables in the aging process, this study conducted three sub-studies to systematically investigate the relationships among aging beliefs, aging attitudes, active aging, and executive function in older adults. The first study focused on the impact of aging beliefs and attitudes on active aging. Aging beliefs and attitudes, regarded as core psychological constructs for coping with aging, may influence older adults’ acceptance of aging and their behavioral participation and health decisions. Active aging reflects older adults’ level of proactive engagement in life, while executive function is a crucial cognitive capacity linked to autonomy and quality of life.Study 1 adopted a cross-sectional survey design, collecting data from 552 older adults in Taiwan using demographic questionnaires and three scales: Aging Beliefs, Aging Attitudes, and Active Aging. Structural equation modeling revealed that positive aging beliefs enhance active aging through the mediation of positive aging attitudes, supporting the mediating role of aging attitudes in this relationship.Study 2 employed latent profile analysis to categorize older adults based on their responses to aging beliefs and attitudes, identifying four distinct psychological profiles: “Moderate Positive–Moderate Negative,” “High Positive–Low Negative,” “High Positive–Moderate Negative,” and “High Positive–High Negative.” These findings indicate a clear heterogeneity in the psychological construction of aging among older adults. Further multinomial logistic regression analysis showed that gender, education level, self-rated health, perceived economic status, and residential location were significant predictors of profile membership.Study 3 employed a tablet-based Executive Function Test System, which included a trail-making test, an updating task, and a Simon switching task to evaluate key components of executive function: inhibition, cognitive flexibility, working memory span, and updating. Analysis showed no significant associations between aging beliefs, attitudes, active aging, and executive function, suggesting that the influence of these psychological variables on cognitive function remains unclear and may be influenced by measurement methods, sample characteristics, or unmeasured moderating or mediating factors.Integrating the findings from the three studies, the results highlight the mediating role of aging attitudes between aging beliefs and active aging, emphasizing its importance in older adults’ behavioral participation. The findings also confirm that aging beliefs and attitudes are distinguishable psychological constructs with latent heterogeneity. However, the expected associations between these psychological variables and executive function were not supported, pointing to the need for further research. Overall, this research contributes to a deeper understanding of the psychological processes of aging and provides theoretical and practical insights for future policies and psychological interventions aimed at promoting healthy aging.