Objective To explore the association between widowhood length and the prevalence of depressive symptoms and the number of chronic diseases and its gender and age specific differences, and to propose corresponding suggestion to improve their health status

Methods The information of 5 642 middle-aged and elderly people in follow up from 2011 to 2018 of China Health and Retirement Longitudinal Survey (CHARLS) were used, and a multilevel growth model was used to analyze the associations between the length of widowhood and the prevalence of depressive symptoms and the number of chronic diseases in the middle-aged and elderly people.

Results Widowhood was associated with the prevalence of depressive symptoms and the number of chronic diseases in the middle-aged and elderly adults, with a significant increase in the prevalence of depressive symptoms within 1 year of widowhood (β=3.62, 95%CI: 2.17−5.06), and a decrease in the prevalence of depressive symptoms after 5 years of widowhood, with similar gender specific results, however, the effect was more significant in age group 45～64 years than in older age group (β=4.00, 95%CI:1.88−6.12). Widowhood was initially associated with a reduction of number of chronic diseases in both men and women and in different age groups (β=−3.05, 95%CI: −3.52−2.57), after 11 years of widowhood, the number of chronic diseases increased (β=0.62, 95%CI: 0.24−1.01), with stronger effect in women and in younger age group.

Conclusions Widowhood is associated with increased prevalence of depressive symptoms in middle-aged and elderly adults, showing acute and lasting effects in both men and women. While widowhood shows a short-term negative association with the number of chronic diseases and would increase the risk for chronic diseases 11 years later, with a more significant effect in women. Widowhood has more significant negative effect on the physical and mental health of younger age group compared with older age group.