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This study aimed to prospectively assess the relationship between depressive symptoms and change in self-rated health (SRH) in middle-aged and elderly Chinese adults. We used data from the China Health and Retirement Longitudinal Study (CHARLS). The final analysis included 8169 participants (≥45 years old) and a multinomial logistic regression model was used to assess the association between baseline depression and follow-up change in SRH. Taking no change in SRH as the reference, depressive symptoms at baseline were positively associated