OBJECTIVE To explore the impact of depressive symptoms on psychological and physical outcomes among elderly living in the residential areas. METHODS A five years follow-up survey of health outcome was carried out among people aged 55 years or above in community without dementia. The outcome measurements included CES-D (center for epidemiological survey, depression scale), MMSE (mini-mental state examination), ADL (activity of daily living), LSIA (life satisfaction index A), index of physical disease and self-rated health questionnaire. A multiple regression analysis was administered to explore the correlation between depressive symptoms and indices of psychological and physical outcomes. RESULTS (1) Data from 2 927 subjects having completed two surveys were analyzed. Baseline data showed significant distribution difference of MMSE, ADL, gender and education among the four CES-D score levels. (2) No significant correlation between CES-D score at baseline and MMSE, ADL, LSIA score at five-year follow up was found after controlling the age, gender, educational level and baseline score of MMSE and ADL. (3) Self-rated general health and memory change were significantly correlated to baseline CESD score under controlling the effects of other baseline variables. (4) The score of CESD was found to be a significant predictor for risks of physical disease and mortality by logistic regression model. The odds ratios were 1.52 (95% CI: 1.19 - 1.95) and 2.68 (95% CI: 1.41 - 5.06) respectively. CONCLUSION Depressive symptoms play an important role on both psychological and physical health outcomes among elderly living in the community.