研究背景與目的：世界人口正迅速朝高齡化發展，高齡者面臨老化所產生的疾病與社會環境因素改變所帶來的生活變化均易導致心理健康問題，其中憂鬱症為高齡者最常見之心理健康問題，而高齡者患有憂鬱症可能造成嚴重影響，近年來有研究指出憂鬱症與營養狀況具有關聯，其中微量營養素在負責調節大腦情緒功能有著重要之作用，眾多營養素中，「維生素D」在許多國家攝取不足的情形十分普遍，過去研究指出體內維生素D可保護大腦神經營養因子與生長因子，並與大腦之維生素D受體結合參與情緒調節功能，若攝取不足可能會影響心理健康，因此本研究旨在探討高齡者膳食加補充劑的維生素D總攝取量與憂鬱症狀之間的關聯性。
研究方法：本研究為橫斷面研究，採用美國健康與營養調查資料庫（National Health and Nutrition Examination Survey，NHANES）2007至2018年之數據，篩選出9,780位60歲以上具有維生素D膳食加補充劑之總攝取量及具有憂鬱症狀評分之高齡者，維生素D總攝取量以四分位數分為四組，憂鬱症狀以患者健康問卷（PHQ-9）的10分作為切分點分成有或無憂鬱症狀兩組，並利用卡方檢定與邏輯斯迴歸分析維生素D總攝取量與高齡者憂鬱症狀之關聯性。　
研究結果：本研究9,780位60歲以上高齡者中，有憂鬱症狀者佔比為8%，女性、有吸菸與飲酒習慣、有睡眠問題、有慢性疾病的高齡者具有憂鬱症狀的風險較高，而65歲以上之年齡層、非西班牙裔白人與黑人、教育程度越高、已婚（同居）、家庭收入與貧困比例≧1、睡眠時數充足及有身體活動的高齡者具有憂鬱症狀的風險較低，調整所有社會人口學與健康狀態因素後，維生素D總攝取量對高齡者憂鬱症狀雖有輕微的保護作用，但攝取量各分位數均不具顯著差異。
結論：維生素D總攝取量與高齡者憂鬱症狀並無直接關聯，憂鬱症狀可能受社會人口學與健康狀態因素影響，因此建議高齡者除了維生素D攝取量維持在各國所制定的標準之外，亦需採取健康的生活方式，例如：具備運動習慣、充足睡眠、戒菸戒酒等健康行為，同時醫療院所及社區可對有慢性病等危險因素之高齡者定期進行憂鬱症狀篩檢及預防，以減少憂鬱症狀的發生。未來需更多前瞻性研究以深入探討維生素D攝取量與憂鬱症狀之間的因果關係。

Background: The world's population is rapidly aging, and the elderly face changes in health and lifestyle due to aging and alterations in social environmental factors. These changes can lead to mental health issues, with depression being the most common psychological problem among the elderly. Depression in the elderly can have serious consequences, and recent studies suggested a correlation between depression and nutritional status. Among various nutrients, "Vitamin D" is commonly insufficiently consumed in many countries. Previous research indicated that adequate levels of vitamin D in the body can protect brain-derived neurotrophic factor and nerve growth factor and combine with receptors in the brain, participating in emotional regulation functions. Insufficient intake may impact mental health. Therefore, the purpose of this study is to explore the relationship between total vitamin D intake and depressive symptoms.
Methods: This study was a cross-sectional investigation utilizing data from the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2018. A total of 9,780 participants aged≧60 were selected based on their total vitamin D intake from dietary sources and supplements, as well as their depressive symptom scores. Total vitamin D intake was divided into four groups based on quartiles, and depressive symptoms were categorized into two groups (with or without symptoms) using a cutoff score of 10 on the Patient Health Questionnaire-9 (PHQ-9). Chi-square tests and Logistic regression analyses were used to examine the association between total vitamin D intake and depressive symptoms in the elderly.
Result: Among 9,780 individuals aged≧60, 8% exhibited symptoms of depression. The result found that female, with smoking and drinking habits, sleep problems and chronic diseases were at a higher risk of depressive symptoms. Those who aged≧65, non-Hispanic white and black, higher education levels, married or cohabited, family PIR≧1, sufficient sleep hours, and engagement in physical activity were associated with a lower risk of depressive symptoms. After adjusting for all sociodemographic and health status factors, the total intake of vitamin D had a slight protective effect of depressive symptoms. However, there were no significant differences in depressive symptoms across different quartiles of vitamin D intake.
Conclusion: The total intake of vitamin D was not directly associated with depressive symptoms in the elderly. Depressive symptoms may be influenced by sociodemographic and health status factors. Therefore, it is recommended that the elderly not only maintain their vitamin D intake within the standards set by each country, but also adopt a healthy lifestyle, such as exercising, getting enough sleep, and quitting smoking and drinking. Additionally, healthcare institutions and communities can conduct regular screening in the elderly with risk factors such as chronic diseases to reduce the occurrence of depressive symptoms. Future research should involve more prospective studies to further explore the causal relationship between vitamin D intake and depressive symptoms.

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