Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study

Abstract

P rospective studies with a follow-up time stretching from midlife to old age have shown that lower socioeconomic status, as indicated by lower education level or occupational grade, predicts a decline in health and functioning in the working population.1-4 This association is similar, if not more pronounced, in old age. 5-7Higher levels of work-related mental and physical strain increase the risk of early retirement and predict a decline in health and an increase in mortality among the working population. 3,[8][9][10][11][12][13][14][15] However, the association between the demands of the work in conjunction with inadequate mental or physical resources (i.e., work ability) 16 and health and functioning in old age has not been studied.17 Using a population-based 28-year follow-up study involving middle-aged municipal employees, we investigated whether work ability in midlife predicts the risk of death and disability during old age among white-collar and blue-collar employees. Methods Participants and designThe Finnish Institute of Occupational Health's Finnish Longitudinal Study on Municipal Employees (FLAME) targeted 7344 individuals aged 44-58 years at baseline in 1981.18 The participants had been chosen at random from members of all municipal professions in Finland. The baseline cohort consisted of 6257 employees (44.7% men), for a response rate of 85.2%. The first questionnaire, which explored work, health and lifestyle factors, was sent out in 1981, and follow-up data were collected in 1985, 1992, 1997 and 2009. Data on work ability were missing for 199 women and 87 men. The analyses in this study are based on the responses of 5971 Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study Mikaela B. von Research CMAJ Background: Poor work ability correlates with increased morbidity and early retirement from the workforce, but the association in old age is not known. We investigated work ability in midlife among white-collar and blue-collar employees as a predictor of mortality and disability 28 years later.

Work ability index and perceived work ability as predictors of disability pension: a prospective study among Finnish municipal employees

“…It should be noted that mortality was relatively high in our sample due to the fact that the sample consisted of middle-aged employees. It has been shown within this sample that the perceived work ability (WAS) was predictive of mortality (29). It can be assumed that the deceased persons had more severe morbidities compared to the survivors.…”

“…The range of the summative index is 7-49. Originally (12), the cut-off points for the levels of work ability were based on the 15 th percentile, median, and 85 th percentile of the distribution of the index in the total population at baseline: (i) poor , (ii) moderate (28)(29)(30)(31)(32)(33)(34)(35)(36), (iii) good (37-43), and (iv) excellent (44-49). For the analyses here, we combined good and excellent work ability into one category.…”

Envelhecimento e trabalho: um desafio para a agenda da reabilitação

“…The structural equation modeling is very useful when one dependent variable becomes independent in subsequent analyzes 56 : for example, the WA variable can be an outcome of rehabilitation and a predictor of well-being, early retirement or morbidity and mortality in advanced age 24,57 .…”

Work-related stress in midlife is associated with higher number of mobility limitation in older age—results from the FLAME study

“…Four-year follow-up data were collected in 1985 (n=5556) (Ilmarinen et al 1991;Tuomi et al 1997;von Bonsdorff et al 2011). The study population includes 5429 persons (3108 women and 2321 men) who had information available on workrelated stress symptoms in 1981 and 1985 and a number of mobility limitations during the follow-up (74 % of target population).…”