Health and well-being after spousal loss among older men and women

Spousal bereavement affects health and well-being, but gender differences and temporal patterns remain unclear. We examined associations between spousal loss and various outcomes by gender over time.

This longitudinal study used three-wave data (2013, 2016, 2019) from the Japan Gerontological Evaluation Study, a nationwide cohort of independent adults aged ≥65 (n = 25,957; 34,252). For those married in 2013, spousal bereavement was assessed in 2016 and categorized into no bereavement, bereavement between 2015 and 2016, and bereavement between 2013 and 2015. We employed an outcome-wide approach to examine 37 outcomes across seven domains: physical and cognitive health, mental health, subjective well-being, social well-being, prosocial and altruistic behaviors, health behaviors, and cognitive social capital. Logistic, modified Poisson, and linear regression were performed with Bonferroni correction.

Spousal loss was associated with higher risks of mortality and dementia among men, with weaker or no associations among women. Widowed men experienced increased depressive symptoms and hopelessness and decreased happiness during the first year, which diminished over time. Conversely, widowed women showed no increase in depressive symptoms and reported increased happiness and life satisfaction later. Both genders reported increased social participation; however, only men experienced reduced social support. Men also showed higher alcohol consumption, whereas women were more likely to attend health screening but became more sedentary.

Men showed greater vulnerability to adverse outcomes, whereas women demonstrated resilience. These results highlight the necessity for gender-specific policy interventions to support recovery and adaptation among widowed older adults.