The effect of retirement on weight

Retirement and cardiovascular disease: a longitudinal study in 35 countries

BACKGROUND

Many countries have been increasing their state pension age (SPA); nonetheless, there is little consensus on whether retirement affects the risk of cardiovascular disease (CVD). This study examined the associations of retirement with CVD and risk factors.

METHODS

We used harmonized longitudinal datasets from the Health and Retirement Study and its sister surveys in 35 countries. Data comprised 396 904 observations from 106 927 unique individuals aged 50-70 years, with a mean follow-up period of 6.7 years. Fixed-effects instrumental variable regressions were performed using the SPA as an instrument.

RESULTS

We found a 2.2%-point decrease in the risk of heart disease [coefficient = -0.022 (95% confidence interval: -0.031 to -0.012)] and a 3.0%-point decrease in physical inactivity [-0.030 (-0.049 to -0.010)] among retirees, compared with workers. In both sexes, retirement was associated with a decreased heart disease risk, whereas decreased smoking was observed only among women. People with high educational levels showed associations between retirement and decreased risks of stroke, obesity and physical inactivity. People who retired from non-physical labour exhibited reduced risks of heart disease, obesity and physical inactivity, whereas those who retired from physical labour indicated an increased risk of obesity.

CONCLUSIONS

Retirement was associated with a reduced risk of heart disease on average. Some associations of retirement with CVD and risk factors appeared heterogeneous by individual characteristics.

The effect of retirement on obesity in women: Evidence from China

Introduction

Retirement has been shown to impact individual health as an important life course, and we examined the impact of retirement on the prevalence of obesity in women based on a female perspective.

Methods

We use data from the five waves of the China Family Panel Study (CFPS) data from 2010 to 2018, with the body mass index (BMI) as the obesity measure. Fuzzy regression discontinuity design (FRDD) is used to overcome the endogeneity of retirement behavior and obesity.

Results

After retirement, the obesity rate among women increased 23.8%-27.4% (p < 0.05). The mechanism is that the activity consumption has not changed significantly, but the energy intake has increased significantly. In addition, we found that the effect of retirement on female obesity was strong heterogeneity.

Conclusions

The study found that retirement will increase the probability of obesity in women.

The Retirement-Health Puzzle: A Sigh of Relief at Retirement?

OBJECTIVES

While the health effects of retirement have been well studied, existing findings remain inconclusive, and the mechanisms underlying the linkage between retirement and health are unclear. Thus, this study aimed to evaluate the effects of retirement on health and its potential mediators.

METHODS

Using a national household survey conducted annually from 2004 to 2019 in Japan (the Japan Household Panel Survey), we evaluated the effects of retirement among Japanese men aged 50 or older on their health, in addition to other outcomes that could be attributed to health changes associated with retirement (i.e., health behaviors, psychological well-being, time use for unpaid activities, and leisure activities). As outcomes are not measured every year, we analyzed 5,794-10,682 person-year observations for 975-1,469 unique individuals. To address the potential endogeneity of retirement, we adopted an instrumental variable fixed-effects approach based on policy changes in eligibility ages for employee pensions.

RESULTS

We found that retirement improved psychological well-being, exercise habits, and time spent on unpaid work. The psychological benefits of retirement were no longer observed for longer durations after retirement, whereas healthy habits and unpaid activities continued. Moreover, health-related improvements after retirement occurred mostly in the higher-income group.

DISCUSSION

Enhancement in personal quality of life owing to increased leisure time and stress reduction from work in addition to lifestyle changes may be key to understanding the health benefits of retirement. Considering the mechanisms behind retirement-health relationships and potential heterogeneous effects is essential for healthy postretirement lives when increasing the retirement age.

Multi-trajectory analysis of changes in physical activity and body mass index in relation to retirement: Finnish Retirement and Aging study

BACKGROUND

Physical activity and body mass index (BMI) have been reported to change around retirement. The objective was to examine the concurrent changes in physical activity and BMI around retirement, which have not been studied before. In addition, the associations of different demographic characteristics with these changes were examined.

METHODS

The prospective cohort study consisted of 3,351 participants in the ongoing Finnish Retirement and Ageing Study (FIREA). Repeated postal survey, including questions on physical activity and body weight and height, was conducted once a year up to five times before and after the retirement transition, the mean follow-up time being 3.6 years (SD 0.7). Group-based multi-trajectory modeling was used to identify several clusters with dissimilar concurrent changes in physical activity and BMI within the studied cohort.

RESULTS

Of the participants, 83% were women. The mean age at the last wave before retirement was 63.3 (SD 1.4) years. Four clusters with different trajectories of physical activity and BMI were identified. BMI remained stable around retirement transition in all four clusters, varying from normal weight to class II obesity. The association of BMI trajectories with physical activity levels were inverse, however, each activity trajectory showed a temporary increase during the retirement transition.

CONCLUSIONS

Retirement seems to have more effect on physical activity than BMI, showing a temporary increase in physical activity at the time of retirement.

A systematic review of evidence on employment transitions and weight change by gender in ageing populations

Background

Becoming unemployed is associated with poorer health, including weight gain. Middle- and older-age adults are a growing segment of workforces globally, but they are also more vulnerable to changes to employment status, especially during economic shocks. Expected workforce exits over the next decade may exacerbate both the obesity epidemic and the economic burden of obesity. This review extends current knowledge on economic correlates of health to assess whether employment transitions impact body weight by sex/gender among middle-aged and older adults.

Methods

Eight bibliometric databases were searched between June and July 2021, supplemented by hand-searches, with no restriction on publication date or country. Longitudinal studies, or reviews, were eligible when examining body weight as a function of employment status change in adults ≥50 years. Data extraction and quality appraisal used predefined criteria; reported findings were analysed by narrative synthesis.

Results

We screened 6,001 unique abstracts and identified 12 articles that met inclusion criteria. All studies examined retirement; of which two also examined job-loss. Overall, studies showed that retirement led to weight gain or no difference in weight change compared to non-retirees; however, reported effects were not consistent for either women or men across studies or for both women and men within a study. Reported effects also differed by occupation: weight gain was more commonly observed among retirees from physical occupations but not among retirees from sedentary occupations. Few studies assessed the role of health behaviours; sleep was the least studied. Most studies were medium quality.

Conclusions

Existing studies do not provide a clear enough picture of how employment transitions affect body weight. Firm conclusions on the impact of employment transitions on weight cannot be made without further high-quality evidence that considers the role of gender, job-type, other health behaviours, and other transitions, like job-loss.

Self-Perception or Objective State: A Further Study of the Effects of Retirement on Health

Against the backdrop of an aging global population and the increasing pressure of medical care expenditures for seniors, this paper used a fuzzy regression discontinuity (FRD) model to explore the effects of retirement on the self-assessed health and objective physical and mental health of older people. Using survey data from the China Health and Retirement Longitudinal Study (CHARLS), our model addresses some relevant academic controversies. Our sample was comprised of male respondents from government agencies, enterprises, and public institutions. The research explored the impact of retirement on lifestyle habits and included an in-depth analysis of the mechanism through which retirement influences different aspects of health. The results show that: (1) Retirement does not have any significant impact on objective health, including depression and self-care ability, but it does cause a notable decline in subjective health assessment. (2) Retirement shortened the sleep time of respondents, which may account for lower scores on subjective health self-evaluations, but it did not lead to any noticeable improvement in habits which are harmful to health, such as smoking and drinking. (3) Marriage can help alleviate the problems of depression and smoking among older people, and education has a somewhat broader positive effect on their health and lifestyles; however, neither factor helps to improve the sleep problems of older people. Therefore, this paper recommends that efforts should be made to both optimize retirement policies and seek further ways to improve the health of the retired population.

Outcomes of bariatric surgery in elderly patients: a registry-based cohort study with 3-year follow-up

BACKGROUND

Elderly patients undergo bariatric surgery less frequently than younger patients. Short- and medium-term outcomes after bariatric surgery in the elderly population remain largely unknown. The objective of the present retrospective, registry-based cohort study was to compare short- and medium-term outcomes between patients <65 and ≥65 years undergoing bariatric surgery, hypothesizing similar outcomes between groups.

METHODS

In this retrospective, registry-based cohort study, the Ontario Bariatric Registry was used to compare data of patients <65 and ≥65 years who underwent Roux-en-Y gastric bypass and sleeve gastrectomy between January 2010 and August 2019 in all accredited bariatric centers of excellence in Ontario, Canada. Primary outcomes were overall postoperative complications. Secondary outcomes included early (<30 days) complications, readmissions, reoperations, mortality, weight loss and comorbidities improvement at 1 and 3 year after surgery.

RESULTS

Data of 22,981 patients <65 and 532 patients ≥65 years were analyzed. Overall postoperative complications were similar between patients <65 and ≥65 years (3388/22,981 [14.7%] vs. 73/532 [13.7%], p = 0.537). Early (<30 days) postoperative complications, readmissions, reoperations, and mortality rates were also similar between groups. Both groups had significant weight loss and comorbidities improvement at 1- and 3-year follow-up. Patients <65 years had superior weight loss (+3.5%, 95% CI: 1.6-5.4, p < 0.001) and higher rates of remission for diabetes mellitus (63.8% vs. 39.3%, p < 0.001), hypertension (37.9% vs. 14.5%, p < 0.001), dyslipidemia (28.2% vs. 9.5%, p < 0.001) and gastroesophageal reflux (65.1% vs. 24.0 %, p < 0.001) compared to patients ≥65 years at 3 year.

CONCLUSIONS

Patients <65 and ≥65 years had similar perioperative morbidity and mortality after bariatric surgery. Even though patients <65 years had overall better medium-term outcomes, bariatric surgery is safe and yields significant weight loss and comorbidities improvement in patients ≥65 years.

Transition to retirement impact on health and lifestyle habits: analysis from a nationwide Italian cohort

Background

Retirement is a life-course transition likely to affect, through different mechanisms, behavioural risk factors’ patterns and, ultimately, health outcomes. We assessed the impact of transitioning to retirement on lifestyle habits and perceived health status in a nationwide cohort of Italian adults.

Methods

We analysed data from a large cohort of Italian adults aged 55–70, derived from linking six waves of the Participation, Labour, Unemployment Survey (PLUS), a national survey representative of the Italian workforce population, conducted between 2010 and 2018. We estimated relative-risk ratios (RRR) of transition to retirement and their corresponding 95% confidence intervals (CIs) for selected behavioural risk factors and health outcomes using multivariable logistic regression models. We used propensity score matching (PSM) to account for potential confounders.

Results

We included 5169 subjects in the study population, of which 1653 retired between 2010 and 2018 (exposed, 32%). Transition to retirement was associated with a 36% increased probability of practising sports (RRR 1.36, 95% CI 1.12–1.64). No statistically significant changes were reported for smoking habit (current smoker RRR: 1.18, 95% CI 0.94–1.46) and BMI (overweight/obese RRR: 0.96, 95% CI 0.81–1.15). Overall, retiring was associated with improved self-rated health status (RRR 1.26, 95% CI 1.02–1.58).

Conclusion

Individual data-linkage of multiple waves of the PLUS can offer great insight to inform healthy ageing policies in Italy and Europe. Transition to retirement has an independent effect on perceived health status, physical activity and selected behavioural risk factors. It should be identified as a target moment for preventive interventions, with particular reference to primary prevention so as to promote health and wellbeing in older ages.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11670-3.

The Relevance of Diet, Physical Activity, Exercise, and Persuasive Technology in the Prevention and Treatment of Sarcopenic Obesity in Older Adults

The aging population faces two conditions that threaten healthy aging: high fat mass (obesity) and low muscle mass and function (sarcopenia). The combination of both-referred to as sarcopenic obesity-synergistically increases the risk of adverse health outcomes. The two conditions often co-occur because they reinforce each other and share common etiologies, including poor nutrition and inactivity. All aging people are at risk of gaining weight and losing muscle mass and could benefit from improvements in physical activity, exercise and dietary intake. one specific window of opportunity is during the transient time of retirement, as older adults already need to restructure their daily activities. It is key to change lifestyle behavior in a sustainable manner, providing scientifically proven, personalized, and acceptable principles that can be integrated in daily life. Health technologies (e.g., applications) can provide promising tools to deliver personalized and appealing lifestyle interventions to a large group of people while keeping health care costs low. Several studies show that health technologies have a strong positive effect on physical activity, exercise and dietary intake. Specifically, health technology is increasingly applied to older people, although strong evidence for long term effects in changing lifestyle behavior is generally lacking. Concluding, technology could play an important role in the highly warranted prevention of sarcopenic obesity in older adults. Although health technology seems to be a promising tool to stimulate changes in physical activity, exercise and dietary intake, studies on long lasting effects and specifically targeted on older people around the time of retirement are warranted.

The impact of socio-demographic features on anxiety and depression amongst navy veterans after retirement: a cross-sectional study

Objective

Retirement from work may trigger various changes in everyday life that affect mental health. The current cross-sectional study, conducted with 231 veterans, examines the relationship between socio-demographic features and both anxiety and depression in navy veterans after retirement. Spielberg’s State-Trait Anxiety Inventory (STAI) was used for anxiety assessment, and the Beck Depression Inventory (BDI) was used for depression assessment. The analysis was performed with the Statistical Package for Social Sciences (SPSS), version 20.0.

Results

It was found that the mean score of state anxiety was 41 and trait anxiety, 38. Severe depression was found in 6.5% of the veterans, moderate in 8.3% and mild in 21.7%. The presence of a serious health problems was an independent predictor of both anxiety and depression’s more serious symptoms. Inversely, the stability in terms of retirement choice was negatively related to depression, while the development of new interests and activities after retirement was negatively related to both anxiety and depression. Further, life satisfaction after retirement was a predictor of lower current anxiety levels among veterans.

Obesity and sleep mismatch between weekends and weekdays in the Korean population according to working status

OBJECTIVES

To investigate whether sleep mismatch between weekends and weekdays is correlated with obesity according to working status and sex in the Korean population.

STUDY DESIGN

This study was conducted using data from the Korea National Health and Nutritional Examination Survey (KNHANES) in 2016. A total of 5,684 subjects (2,453 men and 3,231 women) were divided into subgroups according to age, sex and working status. Sleep mismatch was defined as the difference in sleep duration between weekdays and weekends. In this study, multivariable logistic regression analysis was applied to obtain odds ratios (ORs) for obesity in those with sleep mismatch ≥ 90 min when referenced to those with sleep mismatch < 90 min.

MAIN OUTCOME MEASURES

In the working group, adjusted ORs for obesity were mostly less than 1, but they were not statistically significant among any age or sex groups. However, for the non-working group, men over 60 years of age with sleep mismatch ≥ 90 min showed significantly increased ORs when referenced to those with sleep mismatch < 90 min in every model; the OR in model 4 was 2.89. Women over 60 years of age with sleep mismatch ≥ 90 min also showed higher ORs but they were not statistically significant.

CONCLUSIONS

Men who are not working and over 60 years of age in Korea may be at increased risk of obesity if their sleep mismatch is ≥ 90 min. Therefore, it might be possible to lower the prevalence of obesity in the elderly population by correcting sleep irregularity or through reemployment.

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

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.

The impact of social distancing and self-isolation in the last corona COVID-19 outbreak on the body weight in Sulaimani governorate- Kurdistan/Iraq, a prospective case series study

BACKGROUND

Our area, corona (COVID-19) quarantine was applied from March 14 to April 23, 2020. It was in all forms, including curfew, social distancing, self-quarantine, area quarantine, self-monitoring, and isolation. Due to their concerns about their safety and families, friends, colleagues, and society, everybody was feeling upset, fearful, and anxious. Several studies have reported an association between prolonged sitting time and weight gain. As a way to relieve the tension during that period, people started stocking up on unhealthy foods like over-salted snacks and over-sweetened sugars. People stayed at home, feeling bored, anxious, and stressed and sought relief by eating. Also, there was a rise in emotional eating when the stress of isolation increased by the closure of gyms, casinos, and movie theaters. Moreover, restaurants were allowed to serve the only takeout. Besides, unemployment was skyrocketing, hospitals were overflowing (or were preparing for the possibility), many people were struggling to meet their basic needs, and no one knows when or how it would end.

OBJECTIVE

The study aimed to figure out whether social isolation during the COVID-19 quarantine is consistent and associated with emotional eating and gaining weight or not.

METHODS

A prospective cross-sectional case series study was conducted on 765 patients who have visited the bariatric clinic in Sulaimani city, Kurdistan-Iraq, from April 23 to June 23, 2020. An individual face-to-face interview was conducted with each participant to obtain signed informed consent, provide them with information about the type and the subject of the work, and ask them the study's questions. Each interview lasted between 30 and 45 min and was conducted in a closed session by two Kurdistan Board trainees.

RESULTS

No patient who was quarantined for the COVID-19 was included in the work, but all other patients were included. The selected patients were those who had undergone social distancing (n = 568, 82.48%) by the local law and did self-isolation (n = 134, 17.51%) at home for reasons like having comorbidity, being prone to contamination due to their jobs (health, police, and media workers), having some family members at home with comorbidity (n = 23, 03.00%), and having comorbidity and having undergone social distancing because of their other family members' need to do so for their physical disability (n = 25, 03.27%). Almost all patients (n = 741, 96.86%), even, those with comorbidity (n = 136, 17.78%), were emotionally stable before the outbreak. Seventy-three female patients (09.54%) and138 males (20.65%) sustain their weight during and two months after the outbreak, while the rest (n = 554, 72.41%) gained different amounts of weight.

CONCLUSION

Social distancing and self-isolation in the last COVID-19 outbreak influenced weight gain, but weight gain of less than 2 kg was observed among almost all patients who gained weight (98.05%). The patients who were gain more than 3 kg were mostly females or/and from the center of large cities.

The effect of retirement on biomedical and behavioral risk factors for cardiovascular and metabolic disease

Retirement is a major life event potentially associated with changes in relevant risk factors for cardiovascular and metabolic conditions. This study analyzes the effect of retirement on behavioral and biomedical risk factors for chronic disease, together with subjective health parameters using Southern German epidemiological data. We used panel data from the KORA cohort study, consisting of 11,168 observations for individuals 45-80 years old. Outcomes included health behavior (alcohol, smoking, physical activity), biomedical risk factors (body-mass-index (BMI), waist-to-hip ratio (WHR), glycosylated hemoglobin (HbA1c), total cholesterol/HDL quotient, systolic/diastolic blood pressure), and subjective health (SF12 mental and physical scales, self-rated health). We applied a parametric regression discontinuity design based on age thresholds for pension eligibility. Robust results after p-value corrections for multiple testing showed an increase in BMI in early retirees (at the age of 60) [β = 1.11, corrected p-val. < 0.05] and an increase in CHO/HDL in regular retirees (age 65) [β = 0.47, corrected p-val. < 0.05]. Stratified analyses indicate that the increase in BMI might be driven by women and low educated individuals retiring early, despite increasing physical activity. The increase in CHO/HDL might be driven by men retiring regularly, alongside an increase in subjective physical health. Blood pressure also increased, but the effect differs by retirement timing and sex and is not always robust to sensitivity analysis checks. Our study indicates that retirement has an impact on different risk factors for chronic disease, depending on timing, sex and education. Regular male, early female, and low educated retirees should be further investigated as potential high-risk groups for worsening risk factors after retirement. Future research should investigate if and how these results are linked: in fact, especially in the last two groups, the increase in leisure time physical activity might not be enough to compensate for the loss of work-related physical activity, leading thus to an increase in BMI.

The Effect of Pre-Post Differences in Walking, Health, and Weight on Retirees' Long-Term Quality of Life

This research examined the effect of pre-post differences in walking duration, health, and weight on retirees' long-term quality of life (QoL). It used data from a 2018 randomized mail survey of 483 suburban New Jersey retirees. Ordinary least squares and three-stage least squares models were used. The analysis showed that changes in walking duration during the first 2 years of retirement are directly associated with health change, health change has an effect on long-term QoL, and weight variation of 10 lb or more has an effect on health change and long-term QoL. Although QoL peaks for the sample of retirees at around age 75, people whose average walking duration increased, health improved, and weight did not increase substantially after retirement continued to experience high QoL for a longer time. The results show that people can achieve high long-term QoL by choosing an active lifestyle when transitioning to retirement.

Retirement Effect on Health Status and Health Behaviors in Urban China

This paper analyzes the causal impact of retirement in China on Body Mass Index (BMI) and weight, which are a good gauge of the risk for some diseases. Many middle income developing countries are aging very rapidly and may have to adjust the retirement age to have financially feasible government budgets. It is important to know and understand any plausible health consequences of raising the retirement age in developing countries, and which sub-populations within these countries may be most affected. By using 2011, 2013 and 2015 waves of the China Health and Retirement Longitudinal Study (CHARLS), our identification strategy uses variation in China's mandatory retirement age with a fuzzy discontinuity design to examine an exogenous shock to retirement behavior. Our study finds that retirement will increase weight and BMI among men. This effect is much larger for men with low education. The channel may be that men with low education drink more and take less vigorous exercises after they get retired. Retirement does not affect weight and BMI for women. These effects are robust with different definitions of retirement, narrow retirement bandwidth for samples as well as dropping samples with rural Hukou.

The Association of Pension Income with the Incidence of Type I Obesity among Retired Israelis

Previous studies have identified obesity and overweight as the fourth leading risk factor for global mortality. The objective of the current study is to investigate gender differences and the impact of wealth and income from pensions, sociodemographic variables, and self-assessment of health conditions on the projected probability to become obese in the postretirement age (67 years and older). We are unaware of previous studies, which explored the direct relationship between obesity, monetary income from pensions, wealth, and self-assessment of health conditions. To conduct this research, we make use of an extensive questionnaire concerning the economic and sociodemographic features and health and housing conditions of individuals administered within the framework of the 2015-2016 longitudinal survey conducted by the Israeli Central Bureau of Statistics (CBS). The survey is representative of the Israeli population and also includes information regarding the weight, height, gender, and age of each household member. Results of our study demonstrate that while for the female respondents older than 67, the projected probability of type I obesity (BMI ≥ 30) drops by 0.41% (p=0.0021) to 0.52% (p=0.0001) with an incremental 10,000 NIS (about $2,500) rise of gross annual income from a pension, for the male respondents above 67 years, the projected probability remains unchanged (p=0.4225). This outcome remains robust even when the 2015 BMI measurement of type I obesity (BMI ≥ 30) is controlled. This drop among women attenuates with a cutoff point increase from BMI ≥ 25 (overweight) to BMI ≥ 30 (type I obesity) to BMI ≥ 35 (type II obesity). Further results indicate that for both genders above 67 years and for men above 62 years, the projected BMI drop of one year decreases with income from a pension (p=0.013, p=0.039, and p=0.007, respectively), although the spread around the projection becomes wider. Compared with other martial status categories, for widowed females, the projected probability of obesity and self-reporting on improved health conditions drops by 6.58% (p=0.0419) to 11.28% (p=0.0048) and 6.55% (p=0.0190) to 7.47% (p=0.0036), respectively. For females older than 67, family status divorced drops the projected probability of obesity by 9.25% (p=0.0319). For males older than 67, results show a rise in projected obesity with car ownership by 6.10% (p=0.0897) to 6.41% (p=0.0469) and a drop in projected obesity with academic degree status by 9.93% (p=0.0106) to 10.14% (p=0.0118) and immigration status from American-European countries by 7.67% (p=0.0821) to 8.99% (p=0.0398) and Asian-African countries by 11.63% (p=0.0245) to 11.99% (p=0.02). Research findings stress the differences and similarities in male-female patterns of obesity after the retirement age of 67 years and may be of assistance to welfare and public health experts.

The effects of exit from work on health across different socioeconomic groups: A systematic literature review

Exit from work leads to different effects on health, partially depending on the socioeconomic status (SES) of people in the work exit. Several studies on the effects of exit from work on health across socioeconomic groups have been performed, but results are conflicting. The aim of this review is to systematically review the available evidence regarding the effects of exit from work on health in high and low socioeconomic groups. A systematic literature search was conducted using Pubmed, Embase, Web of Science, CINAHL and PsycINFO. Search terms related to exit from work, health, SES and design (prospective or retrospective). Articles were included if they focused on: exit from work (early/statutory retirement, unemployment or disability pension); health (general, physical or mental health and/or health behaviour); SES (educational, occupational and/or income level); and inclusion of stratified or interaction analyses to determine differences across socioeconomic groups. This search strategy resulted in 22 studies. For general, physical or mental health and health behaviour, 13 studies found more positive effects of exit from work on health among employees with a higher SES compared to employees with a lower SES. These effects were mainly found after early/statutory retirement. In conclusion, the effects of exit from work, or more specific the effects of early/statutory retirement on health are different across socioeconomic groups. However, the findings of this review should be interpreted with caution as the studies used heterogeneous health outcomes and on each health outcome a limited number of studies was included. Yet, the positive effects of exit from work on health are mainly present in higher socioeconomic groups. Therefore, public health policies should focus on improving health of employees with a lower SES, in particular after exit from work to decrease health inequalities.

Change in body mass index during transition to statutory retirement: an occupational cohort study

BACKGROUND

Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics.

METHODS

A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w-3, w-2, w-1), and one to three times after (w+1, w+2, w+3) retirement.

RESULTS

During the 4-year retirement transition (w+1, vs. w-1) men showed decline in BMI, which was most marked among men with sedentary work (-0.18 kg/m2, 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m2, 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m2, 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition.

CONCLUSIONS

In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.

The Associations Between Retirement and Cardiovascular Disease Risk Factors in China: A 20-Year Prospective Study

Despite China's being the largest and most rapidly aging country in the world, there have been no longitudinal studies investigating the relationship between retirement and cardiovascular disease risk factors in China. In this study, we assessed the associations between retirement and systolic blood pressure, diastolic blood pressure, waist circumference, body mass index, smoking status, and alcohol consumption over a 17-year period both before and after retirement among 1,084 people (41.3% women) who participated in the China Health and Nutrition Survey (1991–2011) at least once prior to the year in which they retired and at least once afterward. Piecewise models centered at the year of retirement were applied. Retirement was accompanied by a reduction in diastolic blood pressure, a slowdown in the increase of both systolic blood pressure and waist circumference, and a reduction in the probability of being a heavy alcohol drinker. The association between retirement and blood pressure was stronger for men and for urban dwellers. No significant associations with body mass index or smoking were found. This study suggests that retirement may be beneficial for blood pressure, waist circumference, and alcohol consumption in the Chinese context. Understanding the potential health influence of retirement is essential, given plans to raise the retirement age in China.

Changes in Health and Health Behavior Associated With Retirement

Objectives: While poor health contributes to early work exits, it is less clear how early work exits affect health. This study therefore examines changes in health associated with retirement. Method: Survey data from gainfully employed individuals aged 57 to 66 in 2002 were used to assess changes in health status and behaviors associated with retirement (49%) 5 years later ( N = 546). Results: Compared with workers, retirees were more likely to report improvements in mental health (odds ratio [OR] = 1.67), and less likely to report mental health deteriorations (OR = 0.56). Retirees were more likely to both increase (OR = 2.03) and reduce (OR = 1.87) their alcohol intake, and to increase physical activity (OR = 2.01) and lose weight (OR = 1.75). Discussion: As welfare states aim to extend working life to counteract repercussions of population aging, findings on possible health benefits for retirees may warrant more focus on the pros and cons of a prolonged working life.

Gaining weight through retirement? Results from the SHARE survey

This paper estimates the causal impact of retirement on the Body Mass Index (BMI) of adults aged 50-69 years old, on the probability of being either overweight or obese and on the probability of being obese. Based on the 2004, 2006 and 2010-2011 waves of the Survey of Health, Ageing and Retirement in Europe (SHARE), our identification strategy exploits variation in European Early Retirement Ages (ERAs) and stepwise increases in ERAs in Austria and Italy between 2004 and 2011 to examine an exogenous shock to retirement behavior. Our results show that retirement induced by discontinuous incentives in early retirement schemes causes a 12-percentage point increase in the probability of being obese among men within a two- to four-year period. We find that the impact of retirement is highly non-linear and mostly affects the right-hand side of the male BMI distribution. Additional results show that this pattern is driven by men retiring from strenuous jobs and by those who were already at risk of obesity. In contrast, no significant results are found among women.

Understanding the effect of retirement on health: Mechanisms and heterogeneity

This paper investigates the mechanisms behind the health effects of retirement. Using a Regression Discontinuity Design to exploit financial incentives in the German pension system for identification, I find that retirement improves subjective health status and mental health, while also reducing outpatient care utilization. I explore a wide range of health behaviors, time use, and effect heterogeneity as potential mechanisms. Relief from work-related stress and strain, increased sleep duration as well as more frequent physical exercise seem to be key mechanisms through which retirement affects health.

Does retirement reduce the risk of mental disorders? A national registry-linkage study of treatment for mental disorders before and after retirement of 245,082 Danish residents

Objectives

The effect of retirement on mental health is not well understood. We examined the prevalence of hospital treatment for depression and purchase of antidepressant medication before, during and after retirement in a Danish population sample. We hypothesised that retirement was followed by reduced prevalence of hospital treatment for depression and antidepressant purchase.

Methods

Participants were 245 082 Danish workers who retired between 2000 and 2006. Information on retirement, hospital treatment and antidepressant purchases were obtained from Danish national registers. The yearly prevalence of hospital treatment for depression and antidepressant purchases was estimated in relation to the year of retirement from 5 years prior to the retirement year to 5 years after retirement. Using logistic regressions with generalised estimating equations we analysed the trends in prevalence before, during and after the retirement.

Results

Two of 1000 participants were hospitalised with depression in the year of their retirement and 63 of 1000 purchased antidepressant medication during the retirement year. The prevalence of hospital treatment for depression increased before and around retirement, followed by a slight decline from 2 years after retirement with the prevalence of hospitalisation dropping from 0.21%(retirement +2 years) to 0.16% (retirement +5 years). For antidepressants, we observed a steady increase in purchases before retirement (retirement −2 years). This increase levelled off in the years around retirement, but continued after retirement (retirement +2 years).

Conclusions

Overall, this study did not confirm the hypothesis that retirement is beneficial for mental health measured by hospitalisation with depression and treatment with antidepressants. Although the temporary levelling off of the increase in antidepressant treatment around time of retirement might indicate a beneficial effect, this possible effect was only short-term.

Retirement and a healthy lifestyle: opportunity or pitfall? A narrative review of the literature

BACKGROUND

Retirement is a life-course transition in late adult life that is marked by major changes that may affect healthy lifestyles. Our aim is to give an overview of the current knowledge on changes in smoking, alcohol consumption, physical activity and dietary habits during the transition to retirement. This may provide clues to a better targeting and timing of preventive activities at older age.

METHODS

Literature search in Medline, Scopus, Embase, PsycInfo, Social SciSearch and SciSearch limited to English-language papers published between 2001 and May 2013. Results of 20 original papers are summarized in a narrative review.

RESULTS

Some studies report an increase in alcohol consumption after retirement, whereas others found a decrease or no change at all. Those who retired involuntarily tended to increase their alcohol consumption, whereas retirees who quit voluntarily did not change their alcohol consumption. Leisure-time physical activity seems to increase slightly after retirement, especially moderately intensive physical activity. This increase does not compensate the loss of work-related physical activity such as the work itself or work-related transportation. The studies on changes in smoking and dietary habits were too limited to draw conclusions.

CONCLUSIONS

The transition to retirement is accompanied with both favourable and unfavourable lifestyle changes, depending on the type of lifestyle, lifestyle indicator and the personal situation of the retiree. The (pre-)retirement period may well offer a suitable opportunity for preventive action, for example in pre-retirement programmes, planning or other retirement-related support.

Change in physical activity and weight in relation to retirement: the French GAZEL Cohort Study

OBJECTIVES

To examine the trajectories of physical activity from preretirement to postretirement and to further clarify whether the changes in physical activity are associated with changes in body weight.

DESIGN

Prospective.

SETTING

French national gas and electricity company (GAZEL cohort).

PARTICIPANTS

From the original sample of 20 625 employees, only those retiring between 2001 and 2008 on a statutory basis were selected for the analyses (analysis 1: n=2711, 63% men; analysis 2: n=3812, 75% men). Persons with data on at least one preretirement and postretirement measurement of the outcome were selected.

PRIMARY AND SECONDARY OUTCOME MEASURES

All outcome data were gathered by questionnaires. In analysis 1, the annual prevalence of higher physical activity (walking ≥5 km/week) 4 years before and after retirement was analysed. In analysis 2, changes in leisure-time sport activities (engagement, frequency and manner) from preretirement to postretirement were analysed with simultaneous changes in body weight (kilogram).

RESULTS

In analysis 1 (n=2711), prevalence estimates for 4 years before and 4 years after retirement showed that higher leisure-time physical activity (walking at least 5 km/week) increased by 36% in men and 61% in women during the transition to retirement. This increase was also observed among people at a higher risk of physical inactivity, such as smokers and those with elevated depressive symptoms. In a separate sample (analysis 2, n=3812), change in weight as a function of preretirement and postretirement physical activity was analysed. Weight gain preretirement to postretirement was 0.85 (95% CI 0.48 to 1.21) to 1.35 (0.79 to 1.90) kg greater among physically inactive persons (decrease in activity or inactive) compared with those physically active (p<0.001).

CONCLUSIONS

Retirement transition may be associated with beneficial changes in lifestyle and may thus be a good starting point to preventive interventions in various groups of individuals in order to maintain long-term changes.

Treating obesity in older adults: different risks, different goals, different strategies

Almost 70% of adults 60 years of age and older are overweight according to the National Health and Nutrition Examination Survey 2005-2006. While being overweight is linked to numerous comorbidities and functional impairment, few studies have addressed obesity in elders, and even fewer have addressed sarcopenic obesity. Elder obesity requires different strategies, partly because most approved weight-reduction agents and/or surgical interventions are contraindicated in older adults. Strategies and objectives for weight loss are discussed along with the consultant pharmacist's role.

Differential changes in body mass index after retirement by occupation: hierarchical models

OBJECTIVES

This paper examines whether retirement differentially affects body mass index (BMI) patterns by occupation; occupation embodies differences in on-the-job physical demands as well as socioeconomic characteristics that could lead to variation in post-retirement BMI.

METHODS

We use 12 years of national data from the US and hierarchical linear models to compare BMI trajectories among four broad occupational classes.

RESULTS

We find that those in service and other blue-collar occupations have significant increases in the slopes of their BMI trajectories after retirement, whereas participants in white-collar occupations exhibit no change. This may be due to differences in the physical requirements across blue and white collar jobs or differences in health habits post-retirement.

CONCLUSIONS

Retirement may provide an opportunity to help prevent obesity in older individuals, especially blue collar workers.