背景: 許多研究指出，臨床憂鬱症患者或具有憂鬱症狀的老人與較高的死亡風險相關。然而，過去有關憂鬱症狀與存活相關之社區研究，大部分僅對憂鬱症狀做一次基線或短期的測量，較少針對長期不同的憂鬱症狀變化做探討，因此憂鬱症狀的變化與死亡風險之關係仍有很大程度的未知。
目的: 透過長期追蹤臺灣中老年人之憂鬱症狀，來檢視中高齡者不同的憂鬱症狀軌跡的狀況，並探討這些不同憂鬱症狀軌跡與死亡風險之關係。
方法: 運用台灣地區中老年身心社會生活狀況長期追蹤調查 (Taiwan Longitudinal Study on Aging, TLSA) 四波資料(1996-1999-2003-2007)，共3134位參與者。本研究使用Group-based Trajectory Model來建立憂鬱症狀軌跡，並追蹤不同憂鬱症狀軌跡的老人至2015年，計算其死亡風險和相關影響因子。
結果: 本研究共確立四條憂鬱症狀軌跡，分別為高憂鬱組(5.6%)、低憂鬱組(80.7%)、下降憂鬱組(5.4%)、上升憂鬱組(8.4%)。與低憂鬱組相比，僅上升憂鬱組有較高的死亡風險(HR:1.28, 95% CI=1.04-1.58)，而高憂鬱組和下降憂鬱組並無顯著較高的死亡風險 (高憂鬱組HR:1.08, 95% CI=0.84-1.38；下降憂鬱組HR:1.21, 95% CI=0.93-1.57)。
結論: 本研究之貢獻為利用Group-based Trajectory Model確立台灣中老年人之憂鬱症狀軌跡種類，並瞭解不同憂鬱症狀軌跡的死亡風險，以協助提供有效的預防和治療策略。

Background: Various studies have indicated that both clinical depression and depressive symptoms were associated with higher risk of death in patient and in community samples. However, most previous research was crosstional or short-term design, the association between different courses of depressive symptoms and death is still largely unknown. Therefore, this study aims to explore the relationship between the trajectory of depressive symptoms and the risk of death in middle-aged and older adults in Taiwan.
Methods: A total of 3134 participants from the dataset of ‘Taiwan Longitudinal Study on Aging (TLSA)’were analyzed. The depressive symptoms (CESD) at four waves (1996-1999-2003-2007) were used to identify the depression trajectories by Group-based Trajectory Modal. Mortality rates by trajectory were calculated over a subsequent 8-years period (2007–2015).
Results: Four trajectories of depressive symptoms as high (5.6%), low (80.7%), decreasing (5.4%), and increasing (8.4%) depressive symptoms were identified. Compared with persons in the low depressive symptoms trajectory, people with a trajectory of increasing depressive symptoms (HR: 1.28, 95% CI=1.04-1.58) had a higher risk of death, but not in those with high (HR: 1.08, 95% CI=0.84-1.38) and decreasing (HR: 1.21, 95% CI=0.93-1.57) depressive symptoms.
Conclusions: This study has established the trajectories of depressive symptoms in middle-aged and older adults and examined the risk of death across these different trajectories in order to provide effective strategies for prevention and treatment.

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