Abstract: Objective To examine the prevalence and influencing factors of depression among urban and rural empty-nest elderly living alone in Shandong province.Methods Using multi-stage stratified cluster random sampling,2667 empty-nesters were selected in Shandong province;then the 443 empty-nesters aged ≥60 years and living alone were recruited from the 2667 elderly and surveyed with Geriatric Depression Scale(GDS-15),Social Support Scale(SSRS),and a self-designed questionnaire on general information.Results The detection rate of depression was 19.9%(88/443) among the empty-nest elderly living alone and the detection rate was significantly higher among those without medical insurance(41.9%),not having regular physical exercise(27.9%),with chronic disease(22.7%),and with a poor self-reported economic condition(37.1%) compared to other elderly(all P<0.01).Multivariate logistic regression analysis showed that without medical insurance(odds ratioOR=0.39,95% confidence interval95%CI=0.168-0.907),poor self-reported economic condition(OR=0.28,95% CI=0.165-0.478),with chronic disease(OR=0.48,95% CI=0.244-0.926),not taking part in physical exercise(OR=0.48,95% CI=0.288-0.800) were risk factors for occurrence of depression among the empty-nest elderly living alone.Conclusion The prevalence of depression is high and influenced mainly by self-reported economic condition,whether having chronic disease,and status of physical exercise among the empty-nest elderly living alone in Shandong province.