護理師在健康諮詢中評估一位 75 歲的病人。下列哪項發現被視為「正常」的老化生理變化？
A nurse is assessing a 75-year-old client during a wellness visit. Which finding is considered a normal age-related change?
- ARecent memory loss that interferes with daily activities干擾日常活動的近期記憶喪失
- BA resting heart rate of 110 beats per minute每分鐘 110 次的靜息心率
- CIncreased sensitivity to glare and decreased night vision✓ 正解對眩光敏感度增加及夜間視力下降
- DSudden onset of urinary incontinence突發性尿失禁
健康促進與維護在老年階段的核心是「區分正常老化與病理變化」。正常老化包括：感官功能下降（如選項 C：水晶體變硬、瞳孔縮小導致畏光與暗適應差）、皮膚彈性減少、基礎代謝率下降、肺活量減少等。選項 A（記憶喪失干擾生活）是失智症徵兆，非正常老化。選項 D（尿失禁）雖然在老年人中常見，但它始終是「病理性的」，可能與感染、前列腺肥大或藥物有關，絕非老化必然。選項 B（心跳 110）屬於心搏過速，老化通常伴隨心肌纖維化導致心跳略慢或對運動反應變遲鈍。臨床思路上，護理師應針對視力變化衛教病人環境照明與預防跌倒，這才是促進健康的具體行動。
The core of health promotion and maintenance in old age is to distinguish normal aging from pathologic change. Normal aging includes decreased sensory function (e.g., option C: hardening of the lens and pupillary constriction causing photophobia and impaired dark adaptation), reduced skin elasticity, decreased basal metabolic rate, and reduced vital capacity. Option A (memory loss interfering with daily life) is a sign of dementia, not normal aging. Option D (urinary incontinence), although common in older adults, is always pathologic and may be related to infection, prostatic enlargement, or medication; it is never an inevitable consequence of aging. Option B (heart rate 110) is tachycardia, whereas aging is usually accompanied by myocardial fibrosis that produces a slightly slower heart rate or a blunted response to exercise. Clinically, the nurse should teach the patient about environmental lighting and fall prevention in response to visual changes; this is the concrete action that promotes health.
美國老年護理高度強調「功能性評估」（Functional Assessment），認為能獨立生活比生理數據更重要。台灣臨床環境中，家長常將老人的病態表現（如淡漠、漏尿）視為「老了沒辦法」，護理師需運用專業知識打破這些迷思，推動健康老化。