The Impact of Widowhood on the Mental Health of Older Adults in China: Analysis Based on the Perspective of Mental Frailty Index

Background Population aging in China is deepening, and the widowed rate of the elderly is also on the rise. Widower is one of the most stressful events in the human life course, and its impact also affects the mental health and economic level of widower. In many studies on the impact of widower on the mental health of the elderly at home and abroad, the proxy variables used are traditional indicators, such as subjective well-being, loneliness, depression level, and some studies do not consider the endogeneity between widowhood and health status. Objective To evaluate the impact of widowhood on the mental health of older adults in China, and provide a basis and reference for formulating the mental health intervention program for older adults in China. Methods Using the 2018 China Health and Retirement Longitudinal Study (CHARLS) as the data source, 4 694 older adults aged 60 years and above were selected as study subjects and divided into the widowed group (n=644) and non-widowed group (n=4 050) . The mental frailty index was used as a perspective for evaluating the mental health status of older adults. Using propensity score matching (PSM) model, the propensity score was calculated by using Logit regression analysis, the robustness was tested by using standard deviation variation, common support bar graph and nuclear density distribution, the impact of widowhood on the physical and mental health of older adults was analyzed by using K-nearest neighbor matching, radius matching and kernel matching, and the heterogeneity was tested based on gender, household type and age. Results Compared to the non-widowed group, the mental health of older adults in the widowed group was impaired (P