Changes in social connection, physical activity, and positive psychological attributes associated with grief-related symptoms and depression among bereaved older women during COVID-19.

Older women are disproportionately affected by spousal bereavement, yet little is known about how social, lifestyle, and positive psychological factors correlate with grief-related symptoms and depression following partner loss. We examined these associations among 1946 older women (mean age =84.6 years) in the Women's Health Initiative who experienced spousal or partner loss during COVID-19. Changes in social connection, physical activity, and positive psychological attributes were evaluated in relation to yearning, intrusive thoughts, and depressive symptoms. Multinomial and binary logistic regression estimated adjusted odds ratios; stepwise regression identified parsimonious models. Severe loneliness was associated with approximately threefold higher odds of intense yearning, intrusive thoughts, and depressive symptoms. Conversely, greater optimism, purpose in life, and spiritual well-being correlated with lower symptom burden. More frequent walking was associated with lower depressive symptom odds. These findings highlight potentially modifiable psychosocial and lifestyle factors associated with grief-related and depressive symptoms among bereaved older women.