目標：探討台灣地區老年人「日常生活功能」(Activities of Daily Living, ADL)及「工具性日常生活功能」(Instrumental Activities of Daily Living, IADL)與跌倒的關聯。方法：資料來源為「台灣地區中老年身心社會生活健康狀況長期追蹤調查」。以2003及2007年皆完訪並排除資料不完整者，共3778人為研究對象。在控制人口學、社經、生活方式與健康狀況等變項下，以邏輯斯迴歸分析2003及2007年ADL及IADL與跌倒的關聯。結果：在控制上述變項下，橫斷性分析顯示IADL失能與前一年的跌倒呈顯著關聯，但ADL失能則不。2007年IADL失能1-2、3-4或5-6項的老人，前一年發生跌倒的風險，分別為0項失能者的1.49 (1.17-1.89, p<0.001)，1.71(1.20-2.45, p<0.003)，及2.10倍(1.31-3.38, p<0.002)。ADL 1-2或3-4項失能與跌倒風險不呈關聯，但5-6項失能，則與跌倒風險呈負關聯。縱貫分析結果顯示ADL或IADL皆無預測四年後跌倒風險的能力。嚴重(5-6項) ADL失能則與跌倒風險呈負關聯。結論：本研究顯示IADL具有預測目前或短期內(如一年)老年人跌倒風險的功能，但ADL不具此功能。此結果顯示維持老人IADL功能的重要性。適當的日常運動，正常的營養及定期行動功能篩險將有助於推遲行動功能的衰退，有效降低老年人跌倒的風險。

Objectives: To determine the association between functional ability as indicated by ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living) and the risk of falling in older Taiwanese. Methods: Data were drawn from the 2003 and 2007 datasets of “The Survey of Health and Living Status of the Elderly in Taiwan”. Subjects were 3778 participants who completed both surveys. Logistic regression analysis was employed to determine the association of ADL and IADL status with the risk of falling in 2003 and 2007 after controlling for demographic, lifestyle and health-related variables. Results: In cross-sectional analysis, IADLs but not ADLs were significantly associated with the risk of falling during the prior year. Those who had 1-2, 3-4 or 5-6 dependencies in 2007 had 1.49 (1.17-1.89, p<0.001), 1.71 (1.20-2.25,
p<0.003) and 2.10 (1.31-3.38, p<0.002) times the risk of falling, respectively, during the previous 12 months when compared to those who had no dependency. Mild (1-2 dependencies) or moderate (3-4 dependencies) ADL dependency was not associated with the risk of falling and severe (5-6
dependencies) ADL impairment was negatively associated with the risk of falling. Longitudinal analysis showed that neither IADLs nor ADLs could predict the risk of falling four years later.Conclusions: Results suggested that IADL but not ADL status predicted the current or near term
risk of falling; however, neither was a predictor of the risk four years later. These results highlight the importance of maintaining the functional ability of the elderly through regular exercise, proper
nutrition, and routine monitoring of functional status.