旨在确定老年乳腺癌幸存者的抑郁症状轨迹以及这些轨迹的人口统计学、心理社会、身体健康和癌症相关预测因素。对年龄 60-98 岁、最近诊断的非转移性乳腺癌幸存者 (n = 272) 进行抑郁症状评估症状（流行病学研究中心抑郁量表，CES-D；分数≥16 提示有临床显着的抑郁症状）。在生长混合模型中分析 CES-D 评分，以确定从基线（手术后、全身治疗前）到 3 年年度随访的抑郁轨迹。使用多变量、多项逻辑回归来确定抑郁轨迹的基线预测因素。幸存者具有三种不同的轨迹：稳定（84.6％）、新出现的抑郁症状（10.3％）以及从基线时的高度抑郁症状中恢复，但随着时间的推移缓慢改善（5.1） %）。与稳定幸存者相比，新兴组（OR = 1.16；95% CI = 1.08-1.23）或恢复组（OR = 1.26；95% CI = 1.15-1.38）的患者基线焦虑程度更高。较大的基线赤字积累（虚弱综合衡量标准）与新出现的抑郁症状相关（OR = 3.71；95% CI = 1.90-7.26）。基线时的社会支持较少（OR = 0.38；95% CI = 0.15-0.99），但随着时间的推移，情感（F = 4.13；p = 0.0006）和有形（F = 2.86；p = 0.01）社会支持的改善更大。与抑郁症状的恢复有关。15% 的老年乳腺癌幸存者经历了抑郁症状的出现或恢复过程。基线焦虑、赤字累积和较低的社会支持与较差的结果相关。我们的结果强调了在整个癌症护理过程中进行抑郁症筛查以促进早期干预的重要性。与抑郁症状相关的因素，包括接近诊断的较低水平的社会支持，可以作为干预杠杆。© 2023。作者获得 Springer Science Business Media, LLC（Springer Nature 的一部分）的独家许可。

To identify trajectories of depressive symptoms in older breast cancer survivors and demographic, psychosocial, physical health, and cancer-related predictors of these trajectories.Recently diagnosed nonmetastatic breast cancer survivors (n = 272), ages 60-98 years, were evaluated for depressive symptoms (Center for Epidemiological Studies Depression Scale, CES-D; scores ≥16 suggestive of clinically significant depressive symptoms). CES-D scores were analyzed in growth-mixture models to determine depression trajectories from baseline (post-surgery, pre-systemic therapy) through 3-year annual follow-up. Multivariable, multinomial logistic regression was used to identify baseline predictors of depression trajectories.Survivors had three distinct trajectories: stable (84.6%), emerging depressive symptoms (10.3%), and recovery from high depressive symptoms at baseline that improved slowly over time (5.1%). Compared to stable survivors, those in the emerging (OR = 1.16; 95% CI = 1.08-1.23) or recovery (OR = 1.26; 95% CI = 1.15-1.38) groups reported greater baseline anxiety. Greater baseline deficit accumulation (frailty composite measure) was associated with emerging depressive symptoms (OR = 3.71; 95% CI = 1.90-7.26). Less social support at baseline (OR = 0.38; 95% CI = 0.15-0.99), but greater improvement in emotional (F = 4.13; p = 0.0006) and tangible (F = 2.86; p = 0.01) social support over time, was associated with recovery from depressive symptoms.Fifteen percent of older breast cancer survivors experienced emerging or recovery depressive symptom trajectories. Baseline anxiety, deficit accumulation, and lower social support were associated with worse outcomes.Our results emphasize the importance of depression screening throughout the course of cancer care to facilitate early intervention. Factors associated with depressive symptoms, including lower levels of social support proximal to diagnosis, could serve as intervention levers.© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.