背景及目的：憂鬱症狀在高齡者中具有相當高的盛行率，且為全球失能之重要因素。雖然過去研究發現，身體活動與較低的憂鬱風險相關，高齡者往往面臨達成足夠身體活動量的障礙。因此，降低靜態行為時間可能是一項較具可行性的策略。然而，既有研究多著重於總靜態行為時間，對於其他靜態行為模式（如靜態時間區段與中斷特徵）的實證仍相當有限。本研究旨在檢驗社區高齡者中，以加速規測量之靜態行為模式與一年後憂鬱風險之間的關聯性。
方法：本研究共納入301名年滿60歲之社區成人，參與者來自臺灣北部最大醫學中心的兩個來源（健康檢查及高齡醫學門診服務族群）。靜態行為模式以腰部配戴之加速規（ActiGraph GT3X+）進行測量，憂鬱風險則以15題版老年憂鬱量表評估。研究採用完全校正之邏輯斯迴歸模型，檢驗靜態行為模式與憂鬱風險之橫斷面及性縱貫性關聯；縱貫分析則進一步使用穩定化逆機率加權法進行。
結果：橫斷性分析（n=229）與縱貫性分析（n=141）的樣本中，女性比例約為50%，平均年齡介於76至77歲之間。在完全校正之橫斷面模型中，較長的平均中斷時間與較低的憂鬱風險相關（勝算比= 0.90，95% 信賴區間：0.81-0.98），而總靜態行為時間與平均靜態時間區段則與憂鬱風險無關。在為期一年的追蹤期間，較長的平均靜態時間區段與較高的憂鬱風險相關（勝算比＝1.21，95%信賴區間：1.09-1.36），但總靜態行為時間及平均中斷時間則未呈現明確關係，僅觀察到微弱的證據。
結論：本研究結果顯示，靜態行為模式（包括靜態時間區段與中斷特徵）可能與晚年憂鬱風險相關。藉由增加靜態行為期間的中斷頻率，並減少長時間未中斷的靜態行為，可能是一種可行策略，有助於提升高齡者的情緒福祉及促進心理健康。

Background: Depressive symptoms are highly prevalent among older adults and represent a major contributor to disability worldwide. Although physical activity is found to be associated with a lower risk of depression, older adults often face barriers to achieving sufficient levels. Reducing sedentary time may therefore represent a more feasible strategy. However, previous research has primarily focused on total sedentary time, with limited evidence on other sedentary patterns such as bout and break characteristics. The study aimed to examine the associations between accelerometer-derived sedentary patterns and depression risk over one year among community-dwelling older adults.
Methods: A total of 301 community-dwelling adults aged ≥60 years were recruited from two sources (i.e., health check-up and geriatric outpatient services) at the largest medical center in northern Taiwan. Sedentary behavior patterns were assessed using a waist-worn ActiGraph GT3X+, and depression risk was measured using the 15-item Geriatric Depression Scale. Fully adjusted logistic regression models were used to examine the cross-sectional and longitudinal associations between sedentary behavior patterns and depression risk. The longitudinal analyses were conducted using stabilized inverse probability weighting.
Results: Both the cross-sectional (n=229) and longitudinal (n=141) analytic cohorts were approximately 50% women and had a mean age of 76-77 years. In the fully adjusted cross-sectional models, longer average sedentary break duration was associated with lower odds of prevalent depression risk (odds ratio [OR]=0.90, 95% confidence interval [CI]: 0.81-0.98), whereas total sedentary time and average sedentary bout duration were not associated with depression risk. Over the one-year follow-up, longer average sedentary bout duration was associated with higher odds of incident depression risk (OR=1.21, 95% CI: 1.09-1.36), while total sedentary time and average sedentary break duration showed no clear association, with only weak evidence observed.
Conclusion: These findings highlight the potential importance of sedentary behavior patterns, including sedentary bouts and breaks, for depression risk in later life. Incorporating more frequent interruptions into prolonged sitting and reducing extended uninterrupted sedentary bouts may be a feasible strategy to support emotional well-being and promote mental health in older adults.

Aljassim, N., & Ostini, R. (2020). Health literacy in rural and urban populations: A systematic review. Patient Education and Counseling, 103(10), 2142-2154. https://doi.org/10.1016/j.pec.2020.06.007
Almeida, O. P., & Almeida, S. A. (1999). Short versions of the geriatric depression scale: a study of their validity for the diagnosis of a major depressive episode according to ICD-10 and DSM-IV. Int J Geriatr Psychiatry, 14(10), 858-865. https://doi.org/10.1002/(sici)1099-1166(199910)14:10<858::aid-gps35>3.0.co;2-8
Bergens, O., Nilsson, A., Papaioannou, K. G., & Kadi, F. (2021). Sedentary Patterns and Systemic Inflammation: Sex-Specific Links in Older Adults. Front Physiol, 12, 625950. https://doi.org/10.3389/fphys.2021.625950
Biddle, S. J. H., Henson, J., Davies, M. J., Khunti, K., Sutton, S., Yates, T., & Edwardson, C. L. (2021). Device-assessed total and prolonged sitting time: associations with anxiety, depression, and health-related quality of life in adults. J Affect Disord, 287, 107-114. https://doi.org/10.1016/j.jad.2021.03.037
Boey, K. W. (2000). The Use of GDS-15 Among the Older Adults in Beijing. Clinical Gerontologist, 21(2), 49-60. https://doi.org/10.1300/J018v21n02_05
Cai, H., Jin, Y., Liu, R., Zhang, Q., Su, Z., Ungvari, G. S., Tang, Y. L., Ng, C. H., Li, X. H., & Xiang, Y. T. (2023). Global prevalence of depression in older adults: A systematic review and meta-analysis of epidemiological surveys. Asian J Psychiatr, 80, 103417. https://doi.org/10.1016/j.ajp.2022.103417
Carter, S. E., Draijer, R., Holder, S. M., Brown, L., Thijssen, D. H. J., & Hopkins, N. D. (2018). Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. J Appl Physiol (1985), 125(3), 790-798. https://doi.org/10.1152/japplphysiol.00310.2018
Chen, S., Calderon-Larranaga, A., Saadeh, M., Dohrn, I. M., & Welmer, A. K. (2021). Correlations of Subjective and Social Well-Being With Sedentary Behavior and Physical Activity in Older Adults-A Population-Based Study. J Gerontol A Biol Sci Med Sci, 76(10), 1789-1795. https://doi.org/10.1093/gerona/glab065
Department of Human Resources Development, N. D. C. (2024). Population Projections for the Republic of China (Taiwan): 2024-2070 https://www.ndc.gov.tw/nc_27_38548
Ellingson, L. D., Meyer, J. D., Shook, R. P., Dixon, P. M., Hand, G. A., Wirth, M. D., Paluch, A. E., Burgess, S., Hebert, J. R., & Blair, S. N. (2018). Changes in sedentary time are associated with changes in mental wellbeing over 1 year in young adults. Prev Med Rep, 11, 274-281. https://doi.org/10.1016/j.pmedr.2018.07.013
Eriksson, M., Naas, S., Berginstrom, N., Nordstrom, P., Hansson, P., & Nordstrom, A. (2020). Sedentary behavior as a potential risk factor for depression among 70-year-olds. J Affect Disord, 263, 605-608. https://doi.org/10.1016/j.jad.2019.11.035
Firth, D. (1993). Bias Reduction of Maximum-Likelihood-Estimates. Biometrika, 80(1), 27-38. https://doi.org/10.1093/biomet/80.1.27
Gianfredi, V., Schaper, N. C., Odone, A., Signorelli, C., Amerio, A., Eussen, S., Kohler, S., Savelberg, H., Stehouwer, C. D. A., Dagnelie, P. C., Henry, R. M. A., van der Kallen, C. J. H., van Greevenbroek, M. M. J., Schram, M. T., & Koster, A. (2022). Daily patterns of physical activity, sedentary behavior, and prevalent and incident depression-The Maastricht Study. Scand J Med Sci Sports, 32(12), 1768-1780. https://doi.org/10.1111/sms.14235
Giurgiu, M., & Ebner-Priemer, U. W. (2023). Momentary associations between sedentary bouts, cognitive load and mood in daily life: An ambulatory assessment study. Mental Health and Physical Activity, 25, 100540. https://doi.org/10.1016/j.mhpa.2023.100540
Giurgiu, M., Koch, E. D., Ottenbacher, J., Plotnikoff, R. C., Ebner-Priemer, U. W., & Reichert, M. (2019). Sedentary behavior in everyday life relates negatively to mood: An ambulatory assessment study. Scand J Med Sci Sports, 29(9), 1340-1351. https://doi.org/10.1111/sms.13448
Giurgiu, M., Koch, E. D., Plotnikoff, R. C., Ebner-Priemer, U. W., & Reichert, M. (2020). Breaking Up Sedentary Behavior Optimally to Enhance Mood. Med Sci Sports Exerc, 52(2), 457-465. https://doi.org/10.1249/mss.0000000000002132
Giurgiu, M., Timm, I., Ebner-Priemer, U. W., Schmiedek, F., & Neubauer, A. B. (2024). Causal effects of sedentary breaks on affective and cognitive parameters in daily life: a within-person encouragement design. Npj Ment Health Res, 3(1), 64. https://doi.org/10.1038/s44184-024-00113-7
Hallgren, M., Dunstan, D. W., & Owen, N. (2020a). Passive Versus Mentally Active Sedentary Behaviors and Depression. Exerc Sport Sci Rev, 48(1), 20-27. https://doi.org/10.1249/JES.0000000000000211
Hallgren, M., Nguyen, T. T., Owen, N., Vancampfort, D., Dunstan, D. W., Wallin, P., Andersson, G., & Ekblom-Bak, E. (2020b). Associations of sedentary behavior in leisure and occupational contexts with symptoms of depression and anxiety. Prev Med, 133, 106021. https://doi.org/10.1016/j.ypmed.2020.106021
Hallgren, M., Nguyen, T. T., Owen, N., Vancampfort, D., Smith, L., Dunstan, D. W., Andersson, G., Wallin, P., & Ekblom-Bak, E. (2020c). Associations of interruptions to leisure-time sedentary behaviour with symptoms of depression and anxiety. Transl Psychiatry, 10(1), 128. https://doi.org/10.1038/s41398-020-0810-1
Harvey, J. A., Chastin, S. F., & Skelton, D. A. (2015). How Sedentary are Older People? A Systematic Review of the Amount of Sedentary Behavior. J Aging Phys Act, 23(3), 471-487. https://doi.org/10.1123/japa.2014-0164
Heesch, K. C., Hill, R. L., Aguilar-Farias, N., van Uffelen, J. G. Z., & Pavey, T. (2018). Validity of objective methods for measuring sedentary behaviour in older adults: a systematic review. Int J Behav Nutr Phys Act, 15(1), 119. https://doi.org/10.1186/s12966-018-0749-2
Heinze, G., & Puhr, R. (2010). Bias-reduced and separation-proof conditional logistic regression with small or sparse data sets. Stat Med, 29(7-8), 770-777. https://doi.org/10.1002/sim.3794
Hoffmann, C., & Weigert, C. (2017). Skeletal Muscle as an Endocrine Organ: The Role of Myokines in Exercise Adaptations. Cold Spring Harb Perspect Med, 7(11). https://doi.org/10.1101/cshperspect.a029793
Hsiao, C., Hsueh, M.-C., & Liao, Y. (2022). Associations between objectively measured sedentary behavior patterns and depressive symptoms in older adults: A cross sectional study. Mental Health and Physical Activity, 23, 100471. https://doi.org/10.1016/j.mhpa.2022.100471
Jalali, A., Ziapour, A., Karimi, Z., Rezaei, M., Emami, B., Kalhori, R. P., Khosravi, F., Sameni, J. S., & Kazeminia, M. (2024). Global prevalence of depression, anxiety, and stress in the elderly population: a systematic review and meta-analysis. BMC Geriatrics, 24(1), 809. https://doi.org/10.1186/s12877-024-05311-8
Jefferis, B. J., Sartini, C., Shiroma, E., Whincup, P. H., Wannamethee, S. G., & Lee, I. M. (2015). Duration and breaks in sedentary behaviour: accelerometer data from 1566 community-dwelling older men (British Regional Heart Study). Br J Sports Med, 49(24), 1591-1594. https://doi.org/10.1136/bjsports-2014-093514
Jiang, Y., Zhang, M., & Cui, J. (2024). The relationship between sedentary behavior and depression in older adults: A systematic review and meta-analysis. J Affect Disord, 362, 723-730. https://doi.org/10.1016/j.jad.2024.07.097
Kanning, M., Niermann, C., Ebner-Primer, U., & Giurgiu, M. (2021). The context matters - not all prolonged sitting bouts are equally related to momentary affective states: an ambulatory assessment with sedentary-triggered E-diaries. Int J Behav Nutr Phys Act, 18(1), 106. https://doi.org/10.1186/s12966-021-01170-3
Kilgour, A. H. M., Rutherford, M., Higson, J., Meredith, S. J., McNiff, J., Mitchell, S., Wijayendran, A., Lim, S. E. R., & Shenkin, S. D. (2024). Barriers and motivators to undertaking physical activity in adults over 70-a systematic review of the quantitative literature. Age Ageing, 53(4). https://doi.org/10.1093/ageing/afae080
Lai, T.-F., Hsiao, C., Huang, W.-C., Hsueh, M.-C., & Liao, Y. (2022). Applying the tri-axial accelerometer to measure physical activity and sedentary behavior: A narrative review. Journal of Sports Performance, 9(2), 059-077. https://doi.org/10.53106/240996512022090902001
Li, Q., Zhao, Z., Yang, C., Chen, Z., & Yin, W. (2024). Sedentary Behavior and Risk of Depression in Older Adults: A Systematic Meta-Analysis. Iran J Public Health, 53(2), 293-304. https://doi.org/10.18502/ijph.v53i2.14914
Lim, P. P., Ng, L. L., Chiam, P. C., Ong, P. S., Ngui, F. T., & Sahadevan, S. (2000). Validation and comparison of three brief depression scales in an elderly Chinese population. Int J Geriatr Psychiatry, 15(9), 824-830. https://doi.org/10.1002/1099-1166(200009)15:9<824::aid-gps207>3.0.co;2-c
Lin, C. Y., Kim, B., Liao, Y., & Park, J. H. (2019). Personal, behavioral, and perceived environmental factors associated with late-life depression in older men and women. Psychol Res Behav Manag, 12, 641-650. https://doi.org/10.2147/PRBM.S214524
Liu, C. Y., Lu, C. H., Yu, S., & Yang, Y. Y. (1998). Correlations between scores on Chinese versions of long and short forms of the Geriatric Depression Scale among elderly Chinese. Psychol Rep, 82(1), 211-214. https://doi.org/10.2466/pr0.1998.82.1.211
Liu, P.-C., & Chung, M.-S. (2019). The prevalence and correlates of depression of the elderly in local community centers in Nantou, Taiwan. Taiwanese Journal of Psychiatry, 33(2), 110-113. https://doi.org/10.4103/tpsy.Tpsy_20_19
Matthews, C. E., Chen, K. Y., Freedson, P. S., Buchowski, M. S., Beech, B. M., Pate, R. R., & Troiano, R. P. (2008). Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidemiol, 167(7), 875-881. https://doi.org/10.1093/aje/kwm390
Meredith, S. J., Cox, N. J., Ibrahim, K., Higson, J., McNiff, J., Mitchell, S., Rutherford, M., Wijayendran, A., Shenkin, S. D., Kilgour, A. H. M., & Lim, S. E. R. (2023). Factors that influence older adults' participation in physical activity: a systematic review of qualitative studies. Age Ageing, 52(8). https://doi.org/10.1093/ageing/afad145
Migueles, J. H., Cadenas-Sanchez, C., Ekelund, U., Delisle Nystrom, C., Mora-Gonzalez, J., Lof, M., Labayen, I., Ruiz, J. R., & Ortega, F. B. (2017). Accelerometer Data Collection and Processing Criteria to Assess Physical Activity and Other Outcomes: A Systematic Review and Practical Considerations. Sports Med, 47(9), 1821-1845. https://doi.org/10.1007/s40279-017-0716-0
Miller, A. H., & Raison, C. L. (2016). The role of inflammation in depression: from evolutionary imperative to modern treatment target. Nat Rev Immunol, 16(1), 22-34. https://doi.org/10.1038/nri.2015.5
Mitchell, A. J., Bird, V., Rizzo, M., & Meader, N. (2010). Diagnostic validity and added value of the Geriatric Depression Scale for depression in primary care: a meta-analysis of GDS30 and GDS15. J Affect Disord, 125(1-3), 10-17. https://doi.org/10.1016/j.jad.2009.08.019
National Institute of Mental Health. (2024). Older Adults and Mental Health. Retrieved Jul 7 from https://www.nimh.nih.gov/health/topics/older-adults-and-mental-health
Okely, J. A., Cukic, I., Shaw, R. J., Chastin, S. F., Dall, P. M., Deary, I. J., Der, G., Dontje, M. L., Skelton, D. A., Gale, C. R., & Seniors, U. S. P. t. (2019). Positive and negative well-being and objectively measured sedentary behaviour in older adults: evidence from three cohorts. BMC Geriatr, 19(1), 28. https://doi.org/10.1186/s12877-019-1026-1
Osimo, E. F., Baxter, L. J., Lewis, G., Jones, P. B., & Khandaker, G. M. (2019). Prevalence of low-grade inflammation in depression: a systematic review and meta-analysis of CRP levels. Psychological Medicine, 49(12), 1958-1970. https://doi.org/10.1017/S0033291719001454
Owari, Y. (2021). Relationship between Psychological Distress and Prolonged Sedentary Bouts in the Elderly: Four Period Analysis. Healthcare (Basel), 9(6), 676. https://doi.org/10.3390/healthcare9060676
Park, S. H., & Kwak, M. J. (2021). Performance of the Geriatric Depression Scale-15 with Older Adults Aged over 65 Years: An Updated Review 2000-2019. Clin Gerontol, 44(2), 83-96. https://doi.org/10.1080/07317115.2020.1839992
Pearce, M., Garcia, L., Abbas, A., Strain, T., Schuch, F. B., Golubic, R., Kelly, P., Khan, S., Utukuri, M., Laird, Y., Mok, A., Smith, A., Tainio, M., Brage, S., & Woodcock, J. (2022). Association Between Physical Activity and Risk of Depression: A Systematic Review and Meta-analysis. JAMA Psychiatry, 79(6), 550-559. https://doi.org/10.1001/jamapsychiatry.2022.0609
Pinto, A. J., Bergouignan, A., Dempsey, P. C., Roschel, H., Owen, N., Gualano, B., & Dunstan, D. W. (2023). Physiology of sedentary behavior. Physiol Rev, 103(4), 2561-2622. https://doi.org/10.1152/physrev.00022.2022
Pocklington, C., Gilbody, S., Manea, L., & McMillan, D. (2016). The diagnostic accuracy of brief versions of the Geriatric Depression Scale: a systematic review and meta-analysis. Int J Geriatr Psychiatry, 31(8), 837-857. https://doi.org/10.1002/gps.4407
Rodriguez-Ayllon, M., Neumann, A., Hofman, A., Voortman, T., Lubans, D. R., Yang-Huang, J., Jansen, P. W., Raat, H., Vernooij, M. W., & Muetzel, R. L. (2023). Neurobiological, Psychosocial, and Behavioral Mechanisms Mediating Associations Between Physical Activity and Psychiatric Symptoms in Youth in the Netherlands. JAMA Psychiatry, 80(5), 451-458. https://doi.org/10.1001/jamapsychiatry.2023.0294
Roh, H. W., Hong, C. H., Lee, Y., Oh, B. H., Lee, K. S., Chang, K. J., Kang, D. R., Kim, J., Lee, S., Back, J. H., Chung, Y. K., Lim, K. Y., Noh, J. S., Kim, D., & Son, S. J. (2015). Participation in Physical, Social, and Religious Activity and Risk of Depression in the Elderly: A Community-Based Three-Year Longitudinal Study in Korea. PLoS One, 10(7), e0132838. https://doi.org/10.1371/journal.pone.0132838
Son, J. Y., Zhou, W., Webster-Dekker, K. E., Marriott, D. J., & Larson, J. L. (2024). Association between accelerometry measured patterns of sedentary behaviors and functional status in older adults. Aging Clin Exp Res, 36(1), 11. https://doi.org/10.1007/s40520-023-02644-z
Troiano, R. P., Berrigan, D., Dodd, K. W., Masse, L. C., Tilert, T., & McDowell, M. (2008). Physical activity in the United States measured by accelerometer. Med Sci Sports Exerc, 40(1), 181-188. https://doi.org/10.1249/mss.0b013e31815a51b3
Tsutsumimoto, K., Makizako, H., Doi, T., Hotta, R., Nakakubo, S., Shimada, H., & Suzuki, T. (2017). Prospective associations between sedentary behaviour and incident depressive symptoms in older people: a 15-month longitudinal cohort study. Int J Geriatr Psychiatry, 32(2), 193-200. https://doi.org/10.1002/gps.4461
Wang, J., Li, R., Zhang, L., Gao, X., Zhou, M., Zhang, X., & Ma, Y. (2022). Associations between sedentary behaviour patterns and depression among people aged 60 and older in Hebei Province of China. BMC Public Health, 22(1), 283. https://doi.org/10.1186/s12889-022-12727-7
Watanabe, K., Lu, X., Omori, H., Katoh, T., & Zaitsu, M. (2026). Breaking up Prolonged Sitting Times and Mental Health Among Japanese Workers: A Cross-sectional Study. J Occup Environ Med, 68(2), e129-e134. https://doi.org/10.1097/JOM.0000000000003554
Wermelinger Avila, M. P., Correa, J. C., Lucchetti, A. L. G., & Lucchetti, G. (2022). Relationship Between Mental Health, Resilience, and Physical Activity in Older Adults: A 2-Year Longitudinal Study. J Aging Phys Act, 30(1), 73-81. https://doi.org/10.1123/japa.2020-0264
Werneck, A. O., Kandola, A., Tebar, W. R., Silva, D. R., Stubbs, B., & Christofaro, D. G. D. (2022). Does physical activity moderate the association between device-measured sedentary time patterns and depressive symptoms in adults? Braz J Psychiatry, 44(6), 584-589. https://doi.org/10.47626/1516-4446-2022-2533
Werneck, A. O., Owen, N., Araujo, R. H. O., Silva, D. R., & Hallgren, M. (2023). Mentally-passive sedentary behavior and incident depression: Mediation by inflammatory markers. J Affect Disord, 339, 847-853. https://doi.org/10.1016/j.jad.2023.07.053
WHO. (2024). Ageing and health. Retrieved Jul 5 from https://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Wong, M. T., Ho, T. P., Ho, M. Y., Yu, C. S., Wong, Y. H., & Lee, S. Y. (2002). Development and inter-rater reliability of a standardized verbal instruction manual for the Chinese Geriatric Depression Scale-short form. Int J Geriatr Psychiatry, 17(5), 459-463. https://doi.org/10.1002/gps.633
Wu, C. S., Yu, S. H., Lee, C. Y., Tseng, H. Y., Chiu, Y. F., & Hsiung, C. A. (2017). Prevalence of and risk factors for minor and major depression among community-dwelling older adults in Taiwan. Int Psychogeriatr, 29(7), 1113-1121. https://doi.org/10.1017/S1041610217000199
Yadava, D., & Chumber, P. (2024). Late-Life Depression. In G. Bennett & E. Goodall (Eds.), The Palgrave Encyclopedia of Disability (pp. 1-11). Springer Nature Switzerland. https://doi.org/10.1007/978-3-031-40858-8_153-1
Yesavage, J. A., & Sheikh, J. I. (2008). 9/Geriatric Depression Scale (GDS). Clinical Gerontologist, 5(1-2), 165-173. https://doi.org/10.1300/J018v05n01_09
Yu, K., Yang, Q., Wang, J., & Zeng, B. (2025). Accelerometer-Derived Physical Activity, Sedentary Behavior, and the Risk of Depression and Anxiety in Middle-aged and Older Adults: A Prospective Cohort Study of 71,556 UK Biobank Participants. Am J Geriatr Psychiatry, 33(5), 512-523. https://doi.org/10.1016/j.jagp.2024.10.015
Zhang, H. G., Wang, J. F., Jialin, A., Zhao, X. Y., Wang, C., & Deng, W. (2025). Relationship between multimorbidity burden and depressive symptoms in older Chinese adults: A prospective 10-year cohort study. J Affect Disord, 389, 119714. https://doi.org/10.1016/j.jad.2025.119714