The Impact of Retirement on Cardiovascular Disease and Its Risk Factors: A Systematic Review of Longitudinal Studies

Abstract

Background and Objectives People are now spending longer in retirement than ever before and retirement has been found to influence health. This study systematically reviewed the impact of retirement on cardiovascular disease (CVD) and its risk factors (metabolic risk factors, blood biomarkers, physical activity, smoking, drinking, and diet). Research Design and Methods Longitudinal studies published in Medline, Embase, Social Science Citation Index, PsycINFO, and Social Policy and Practice were searched. No language restrictions were applied if there was an English abstract. Eighty-two longitudinal studies were included after critical appraisals. Results Studies in the United States often found no significant effect of retirement on CVD, while studies in European countries, except France, showed a detrimental effect of retirement on CVD. Results from the United States and several European countries consistently show that retirement increase adiposity measures among those retired from physically demanding jobs. For diabetes and hypertension, five out of nine studies suggest no effect of retirement. Retirement has been repeatedly linked to increasing leisure-time physical activity but may reduce work- and transport-related physical activity in turn. Most studies showed that retirement either decreased smoking or had no effect on smoking. The evidence did not show a clear conclusion on drinking. Only a few studies have assessed the impact on diet and blood biomarkers. Discussion and Implications Effect of retirement varies according to the health outcomes studied and country of the study population. Policy concerning extending the retirement age needs to focus on ensuring they are suited to the individual.

Leisure-Time Physical Activity, Sedentary Behaviour and Diet Quality are Associated with Metabolic Syndrome Severity: The PREDIMED-Plus Study

“…Our results in which women showed higher levels of MetSSS is in agreement with previous observations in which women showed a higher risk of CV mortality attributed to the higher prevalence of MetS in elderly women [29] and the distribution of central adiposity, insulin resistance, and hormonal regulation [30]. In accordance with our results showing that retired participants were less frequent in the highest MetSSS tertiles, previous observations have associated retirement with increasing LTPA [31]. Smoking is associated with MetS and its individual components, and smoking cessation is beneficial to MetS [32].…”

Socioeconomic and behavioral determinants of cardiovascular diseases among older adults in Belgium and France: A longitudinal analysis from the SHARE study

“…The present study showed, retired older adults have a higher risk of CVD after adjusted for age, sex and other socioeconomic characteristics. A recent systematic review indicated the impact of retirement on the rate of CVDs and risk factors varies across countries, in which studies in the European countries showed a detrimental effect of retirement on CVDs [ 44 ]. Pedron and colleagues identified male and low-educated retirees as potential high-risk groups for worsening CVD risk factors after retirement [ 45 ].…”

To Work or Not to Work? The Effect of Higher Pension Age on Cardiovascular Health

“…In contrast, the effect of retirement on physical health outcomes (in particular physical health indexes, CVD risk factors, hospitalizations, mortality, and self‐reported general health) is less clear, as both positive (Carrino, Glaser, and Avendano 2018; Coe and Zamarro 2011; Insler 2014), null (Dayaram and McGuire 2019; Hagen 2018; Hernaes et al 2013; Johnston and Lee 2009), and negative effects have been reported (Behncke 2012; Dave, Rashad, and Spasojevic 2008). Xue et al (2019) performed a systematic review of longitudinal studies on the impact of retirement on CVD and its risk factors and identified eighty‐two articles on the topic. Thanks to the very detailed synthesis of the papers included in their review, it was possible to discover that only sixteen of the eighty‐two studies adopted a causal design and only two of these focused on diagnosis of CVD as outcome, while the remaining analyzed the effect of retirement on adiposity measures, metabolic chronic conditions, healthy diet, physical activities, and smoking.…”

“…Surprisingly, the relationship between cardiovascular diseases and age at retirement is an understudied topic. As has emerged by a recent systematic review of the literature on the effect of retirement on cardiovascular diseases and its risk factors (Xue et al 2019), only two out of the eighty-two reviewed articles employed a causal design to study the impact of retirement on diagnosis of cardiovascular diseases (hereafter: CVD), while the effect of age at retirement on CVD has never been investigated. Most previous studies indeed looked at retirement rather than retirement age.…”