Does work after retirement affect health-related quality of life: Evidence from a propensity score matching study in China

AIM

Extending working life is considered as an important initiative to respond to the population aging and pension payment dilemma. This study aimed to investigate whether work after retirement is related to improved health-related quality of life.

METHODS

We used two waves of data from the China Health and Retirement Longitudinal Study in 2011 and 2018. Work after retirement was ascertained based on self-reported retirement and work status, and health-related quality of life (HRQOL) was measured with the three-level EuroQol five-dimensions. The impact of work after retirement on HRQOL was analyzed using the propensity score matching with difference-in-difference approach.

RESULTS

A total of 1043 retirees were included. The results showed that work after retirement was associated with significant improvement in HRQOL among retirees (β = 0.072, P < 0.001). Heterogeneity analyses did not show specificity on sex (P for sex interaction >0.05), but older-aged retirees seemed more sensitive to the benefits of work after retirement on HRQOL than their younger-aged counterparts (≥65 years: β = 0.167, P < 0.001 vs <65 years: β = -0.047, P > 0.05; P for age interaction = 0.010).

CONCLUSIONS

Work after retirement shows a positive impact on HRQOL among community-dwelling adults in China. Policy-makers should take the health of retirees into account when implementing policies related to delayed retirement, and reduce health inequity. Geriatr Gerontol Int 2024; ••: ••-••.

Socioeconomic support, quality of life, and prognosis of frailty among the older adults

Background

Although socioeconomic support is recommended for frailty management, its association with the prognosis of frailty is unclear.

Methods

Using data from participants aged ≥65 years in the Chinese Longitudinal Healthy Longevity Survey (2008-2018), the associations between socioeconomic support (source of income, medical insurance, community support, living status), onset of prefrailty/frailty, and worsening of prefrailty, were analyzed using multinominal logistic regression models. The associations between self-reported low quality of life (QoL) and reversion of prefrailty/frailty were analyzed using multivariate logistic regression models. Associations with mortality risk were analyzed using Cox proportional hazard regression models.

Results

A total of 13,859 participants (mean age: 85.8 ± 11.1 years) containing 2056 centenarians were included. Financial dependence was a risk factor for low QoL among prefrail/frail individuals, but not among robust individuals. Having commercial or other insurance, and receiving social support from the community were protective factors for low QoL among prefrail/frail individuals and for the worsening of prefrailty. Continuing to work was a risk factor for low QoL, but a protective factor for worsening of prefrailty. A negative association between continuing to work and mortality existed in prefrail individuals aged <85 years and ≥85 years. Living alone was a risk factor for low QoL, but was not significantly associated with frailty prognosis.

Conclusions

Prefrail and frail individuals were vulnerable to changes in socioeconomic support and more sensitive to it compared with robust individuals. Preferential policies regarding financial support, social support, and medical insurance should be developed for individuals with frailty.

The relevance of perceived work environment and work activities for personality trajectories in midlife

OBJECTIVES

Work is an important developmental context in adulthood, yet little is known about how it contributes to personality trajectories in midlife. The present study examines how subjectively perceived work environment (autonomy, innovation, social integration, stress) and objectively measured work activities (activities related to information and people, physical/manual activities) are related to levels of Big Five personality traits at age 44 and to change over 20 years.

METHODS

We analyzed four-wave longitudinal data from N = 374 participants (born 1950-1952; Mage T1 = 44 years, SD = 1; 44% women) from the Interdisciplinary Longitudinal Study of Adult Development and Aging (ILSE) within the structural equation modeling framework.

RESULTS

At baseline, subjective perceptions of work environments showed a higher number of significant associations with personality than objective work activities. Over time, small declines in neuroticism and extraversion and small increases in agreeableness and conscientiousness were observed, which were largely independent of work characteristics.

CONCLUSIONS

Our findings show slight changes in most Big Five traits from age 44 to 64, which were mostly unrelated to work characteristics. More research is needed to uncover the sources and dynamics of personality trait change in midlife and the role of work for personality trajectories.

The associations of physical incapacity and wealth with remaining in paid employment after age 60 in five middle-income and high-income countries

Previous studies on health and socioeconomic determinants of later-life labour force participation have mainly come from high-income European countries and the United States of America (USA). Findings vary between studies due to different measures of socioeconomic status and labour force outcomes. This study investigated longitudinal associations of physical incapacity and wealth with remaining in paid employment after age 60 in middle- and high-income countries. Using harmonised cohort data in the USA, England, Japan, Mexico and China (N=32,132), multilevel logistic regression was applied for main associations. The age-related probabilities of remaining in paid employment by physical incapacity and wealth were estimated using marginal effects. This study found that physical incapacity predicted lower odds of remaining in paid employment in each country. Wealth was associated with higher odds of remaining in paid employment in the USA, England, and Japan, but not in Mexico. Probabilities of remaining in paid employment were high in Mexico but low in China. The absolute difference in the probability of remaining in paid employment between the richest and the poorest groups was greater in the USA than that in any other country. In the USA, England and Japan, the inverse association between physical incapacity and remaining in paid employment could be partially compensated by wealth only when physical incapacity was not severe. National policies, including considering older adults' changing capacities for job placement and prioritising the provision of supportive services for socioeconomically disadvantaged older adults, developing pathways for informal workers to access social security and pension coverage, and encouraging employers to hire socioeconomically disadvantaged older workers and enhancing their employability, could be facilitated. Future studies, such as exploring health and socioeconomic determinants of remaining in part-time and full-time paid employment separately in more countries, and the moderating effects of relevant policies on these associations, are needed.

Aging engineers' occupational self-efficacy-a mixed methods study

Introduction

Engineers' work has become more complex with increased demands in today's changing working life. Self-efficacy is essential to successfully adapt to work-related changes and to cope with adverse job demands. However, less is known about aging engineers' occupational self-efficacy. Therefore, this study explores facilitators and barriers to aging engineers' occupational self-efficacy beliefs to continue working until expected retirement age. An additional purpose is to explore if any of the aspects described by the engineers are more prominent.

Methods

The study design was exploratory, using mixed methods with a qualitative to quantitative approach. A total of 125 engineers, aged between 45 and 65 years, answered two open-ended survey questions about what positively and negatively affect their occupational self-efficacy beliefs to continue working. First, data was analyzed using an inductive manifest qualitative content analysis. Next, descriptive statistics were performed based on the results of the qualitative study.

Results

The analyses revealed that health and working conditions that affect health were crucial facilitators and barriers for the aging engineers' occupational self-efficacy to continue working until expected retirement age. Furthermore, the engineers emphasized competence, motivation from meaningful tasks, family and leisure, and private economy.

Discussion

The aging engineers' own health seems to be prominent in their self-efficacy regarding a full working life; consequently, support still needs to address issues affecting health.

Will Working Longer Enhance the Health of Older Adults? A Pooled Analysis of Repeated Cross-sectional Data in Japan

BACKGROUND

Encouraging older adults to continue working longer would be a realistic solution to the shrinking labor force, which is a result of the aging population. This study examined whether working longer improves the health of older adults.

METHODS

We used repeated cross-sectional data from 1,483,591 individuals aged 55-69 years collected from 11 waves of a nationwide population-based survey conducted in Japan from 1986 to 2016. We estimated pooled regression models to explain health outcomes by work status, controlling for potential endogeneity biases. Based on the estimation results, we conducted simulations to predict the health impact of policy measures that encourage older adults to participate in the labor force.

RESULTS

The regression analysis showed that work status had a mixed health impact. For example, work reduced the probability of poor self-rated health by 6.7 (95% confidence interval [CI], 6.2-7.2) percentage points and increased that of psychological distress by 12.2 (95% CI, 11.3-13.1) percentage points. The simulation results showed that raising both the mandatory retirement age and eligibility age for claiming public pension benefits to 70 years would increase the employment rate by 27.8 (standard deviation [SD], 4.2) percentage points among those aged 65-69 years, which would reduce their probability of poor self-rated health by 1.8 (SD, 0.4) percentage points and raise that of psychological distress by 4.1 (SD, 0.8) percentage points for that age group.

CONCLUSION

The results suggest the need to pay attention to the health outcomes of policy measures that encourage older adults to work longer.

Simultaneous employment and depressive symptom trajectories around retirement age in Chile

Objectives: Over the last decade, an increasing number of empirical studies have examined long-term patterns of depression among adults around retirement age and identified employment status as a crucial determinant. However, most research has examined associations between cross-sectional measures of employment and prospective depression patterns, overlooking the changing nature of employment statuses, particularly close to retirement age. Furthermore, most knowledge in this field comes from studies conducted in developed countries in Western Europe and North America. To address these gaps, this study examined simultaneous trajectories in the employment and depressive symptom domains among two age groups of Chileans before and after the standard retirement age. Method: Using population-representative data and longitudinal statistical methods, we identified different trajectory types among two age groups (one aged 56-65 and another aged 66-75, at baseline) and characterized them according to social and health characteristics.Results: We found that trajectories defined by permanent employment were accompanied by lower depressive symptoms than trajectories indicating either retirement or inactivity. However, trajectories combining employment and the absence of depressive symptoms were primarily followed by individuals with advantaged health and social statuses at the baseline. Conclusion: Public policies aimed at promoting the mental health of older adults through their labor market integration risk forcing individuals who have accumulated social and health disadvantages across the life course to work longer.

Occupational safety and health guidelines in relation to COVID‐19 risk, death risk, and case‐fatality proportion: An international, ecological study

Background

Coronavirus disease 2019 (COVID‐19) began in 2019 with several unknown factors. The World Health Organization (WHO) subsequently developed COVID‐19 occupational safety and health (OSH) guidelines to reduce occupational COVID‐19 transmission. Many countries also developed their own COVID‐19 OSH guidelines, but whether these guidelines included WHO's guidelines and whether including WHO's guidelines in countries' COVID‐19 OSH guidelines reduced COVID‐19 transmission is unknown.

Objectives

The objectives of our study were to (1) compare the COVID‐19 OSH guidelines of several countries to WHO's OSH guidelines, (2) estimate associations between characteristics of countries and their OSH guidelines and the number of WHO's OSH guidelines included in countries' OSH guidelines, and (3) estimate associations between WHO's OSH guidelines included in countries' OSH guidelines and COVID‐19 risk, death risk, and case‐fatality proportion.

Methods

This study represents international, ecological research of 36 countries from all six world health regions. Countries' COVID‐19 OSH guidelines were compared with WHO's OSH guidelines. Linear regression models adjusted for potential confounders were used to estimate associations of interest.

Results

The median number of WHO's 15 COVID‐19 OSH guidelines included in countries' COVID‐19 OSH guidelines was eight. Countries' COVID‐19 OSH guidelines focused on workers included significantly more of WHO's COVID‐19 OSH guidelines than countries' COVID‐19 OSH guidelines focused on general populations. Including “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment” in countries' COVID‐19 OSH guidelines were significantly related to decreased COVID‐19 risk, death risk, and/or case‐fatality proportion.

Conclusions

Countries' COVID‐19 OSH guidelines should include WHO's guidelines, focus on workers, and include “provide personal protective equipment for workers” and “create workplace policy for wearing personal protective equipment.”

Retirement type and cognitive functioning in Japan

OBJECTIVES

A growing literature examines the effect of retirement on cognitive function, but pays little attention to how this relationship may depend upon the nature of retirement. Of particular importance is the growing prevalence of gradual retirement characterized by continued employment - either with a new employer or with the same employer - after retiring from a career job.

METHODS

We use data from men and women aged 50 or older in the Japanese Study of Aging and Retirement to examine the effects of full retirement, partial retirement with the same employer, and partial retirement with a new employer on cognitive function. Our analyses consider the moderating role of career job complexity and exploit distinctive features of the Japanese public pension and mandatory retirement systems to estimate the causal effect of retirement type on cognition.

RESULTS

Results indicate that partial retirement with the same employer has a significant and adverse effect on cognitive function (relative to those not yet retired). In contrast, those who experienced either full retirement or partial retirement with a new employer were, on average, no different from those still in their career job. Partial retirement with a new employer has a beneficial effect on cognition among those who had a high complexity career job.

DISCUSSION

Results are consistent with the idea that novel work exposures and experiences have a beneficial effect on cognition. They also suggest that ongoing policy efforts to promote partial retirement with the same employer may have unexpected adverse implications for cognitive health.

"Working old-old": Psychological well-being, cognitive abilities and physical health of employed and self-employed Europeans aged 75

BACKGROUND

Recent research deals with the effects of employment/self-employment of elderly on mental and physical health. However, the rising group of "old-old", aged 75 and above, is almost missing in this research.

OBJECTIVES

This study aimed to analyze psychological well-being, cognitive abilities and physical health of employed/self-employed and retired Europeans aged 75 and above ("old-old").

METHODS

We used data recently collected by Survey of Health, Ageing and Retirement in Europe (SHARE). Our final sample consisted of N = 9,884, 57.69%were female. Employed or self-employed (vs. retired) rate was 30.20%for male and 28.88%for female. Mean age of the sample was 81.07 (SD = 4.90).

RESULTS

Employed/self-employed "old-old" showed significant better psychological well-being, cognitive abilities and physical health than their retired counterparts. Age of the groups did not differ. Further analysis indicated the close connection between physical health (i.e. chronic diseases, negative self-perceived health, physical inactivity and ADL number of limitations) and employment/self-employment status.

CONCLUSIONS

Against the background of continuity theory of ageing future research has to focus on the growing group of "old-old" still working.

A New Path to Address Multimorbidity? Longitudinal Analyses of Retirement Sequences and Chronic Diseases in Old Age

Chronic disease and multimorbidity are growing health challenges for aging populations, often coinciding with retirement. We examine late-life predictors of multimorbidity, focusing on the association between retirement sequences and number of chronic diseases. We modeled the number of chronic diseases as a function of six types of previously identified 10-year retirement sequences using Health and Retirement Study (HRS) data for 7,880 Americans observed between ages 60 to 61 and 70 to 71. Our results show that at baseline, the adjusted prevalence of multimorbidity was lowest in sequences characterized by late retirement from full-time work and highest in sequences characterized by early labor-force disengagement. Age increases in multimorbidity varied across retirement sequences, though overall differences in prevalence persisted at age 70 to 71. Earlier life disadvantages did not moderate these associations. Findings suggest further investigation of policies that target health limitations affecting work, promote continued beneficial employment opportunities, and ultimately leverage retirement sequences as a novel path to influence multimorbidity in old age.

Is working in later life good for your health? A systematic review of health outcomes resulting from extended working lives

Background

Work, rather than unemployment, is recognised as being good for health, but there may be an age when the benefits are outweighed by adverse impacts. As countries around the world increase their typical retirement age, the potential effect on population health and health inequalities requires scrutiny.

Methods

We carried out a systematic review of literature published since 2011 from developed countries on the health effects of employment in those over 64 years of age. We completed a narrative synthesis and used harvest plots to map the direction and volume of evidence for the outcomes reported. We followed the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist in our methods and reporting.

Results

We identified seventeen relevant studies, which were of cohort or cross-sectional design. The results indicate evidence of beneficial or neutral effects from extended working on overall health status and physical health for many employees, and mixed effects on mental health. The benefits reported however, are most likely to be for males, those working part-time or reducing to part-time, and employees in jobs which are not low quality or low reward.

Conclusions

Extending working life (particularly part time) may have benefits or a neutral effect for some, but adverse effects for others in high demand or low reward jobs. There is the potential for widening health inequalities between those who can choose to reduce their working hours, and those who need to continue working full time for financial reasons. There is a lack of evidence for effects on quality of life, and a dearth of interventions enabling older workers to extend their healthy working life.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-11423-2.

Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors

Evidence suggests that contemporaneous labor force participation affects cognitive function; however, it is unclear whether it is employment itself or endogenous factors related to individuals’ likelihood of employment that protects against cognitive decline. We exploit innovations in counterfactual causal inference to disentangle the effect of postponing retirement on later-life cognitive function from the effects of other life-course factors. With the U.S. Health and Retirement Study (1996–2014, n = 20,469), we use the parametric g-formula to estimate the effect of postponing retirement to age 67. We also study whether the benefit of postponing retirement is affected by gender, education, and/or occupation, and whether retirement affects cognitive function through depressive symptoms or comorbidities. We find that postponing retirement is protective against cognitive decline, accounting for other life-course factors (population: 0.34, 95% confidence interval (CI): 0.20,0.47; individual: 0.43, 95% CI: 0.26,0.60). The extent of the protective effect depends on subgroup, with the highest educated experiencing the greatest mitigation of cognitive decline (individual: 50%, 95% CI: 32%,71%). By using innovative models that better reflect the empirical reality of interconnected life-course processes, this work makes progress in understanding how retirement affects cognitive function.

•

Research is inconclusive as to employments' protection against cognitive decline.

•

Causal inference models can better reflect interconnected life-course processes.

•

The parametric g-formula shows a substantial protective effect of ongoing employment.

•

Protective effect holds for all subgroups, but is greatest for the highest educated.

Association between social network and functional disability in brazilian elderly

OBJECTIVE

to verify the association between social network and functional disability in elderly Brazilians.

METHODS

a cross-sectional study with secondary data of 11,177 elderly people, available on Brazilian Institute of Geography and Statistics' website. Social network components were having trusted friends/relative, living with their spouse, practicing social activity, performing voluntary or paid work. The outcome was functional disability, measured by the difficulty in performing instrumental and basic activities of daily living. Logistic regression models were used.

RESULTS

disability prevalence for instrumental activities was 28.0% (95%CI: 26.7-29.4), and for basic activities, 15.5% (95%CI: 14.4-16.6). Not having components social network components was associated with greater chances of functional disability, especially among women.

CONCLUSION

there was an association between not having social network components with functional disability. There are differences in this association according to sex. Strengthening actions that expand social network can reduce the chance of this outcome in elderly people.

A Mediterranean lifestyle is associated with favourable cardiometabolic markers in people with non-dialysis dependent chronic kidney disease

Adherence to a Mediterranean lifestyle may be a useful primary and secondary prevention strategy for chronic kidney disease (CKD). This cross-sectional study aimed to explore adherence to a Mediterranean lifestyle and its association with cardiometabolic markers and kidney function in 99 people aged 73⋅2 ± 10⋅5 years with non-dialysis dependant CKD (stages 3-5) at a single Australian centre. Adherence was assessed using an a priori index, the Mediterranean Lifestyle (MEDLIFE) index. Cardiometabolic markers (total cholesterol, LDL-cholesterol, HbA1c and random blood glucose) and kidney function (estimated GFR) were sourced from medical records and blood pressure measured upon recruitment. Overall, adherence to a Mediterranean lifestyle was moderate to low with an average MEDLIFE index score of 11⋅33 ± 3⋅31. Adherence to a Mediterranean lifestyle was associated with employment (r 0⋅30, P = 0⋅004). Mediterranean dietary habits were associated with cardiometabolic markers, such as limiting sugar in beverages was associated with lower diastolic blood pressure (r 0⋅32, P = 0⋅002), eating in moderation with favourable random blood glucose (r 0⋅21, P = 0⋅043), having more than two snack foods per week with HbA1c (r 0⋅29, P = 0⋅037) and LDL-cholesterol (r 0⋅41, P = 0⋅002). Interestingly, eating in company was associated with a lower frequency of depression (χ ² 5⋅975, P = 0⋅015). To conclude, Mediterranean dietary habits were favourably associated with cardiometabolic markers and management of some comorbidities in this group of people with non-dialysis dependent CKD.

Reliability and validity of Healthy Fitness Measurement Scale Version1.0 (HFMS V1.0) in Chinese elderly people

Purpose

We examined the reliability and validity of the Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) specifically on elderly people in China.

Methods

We carried out a cross-sectional study in December 2020 and enrolled 800 elderly people through stratified sampling technique, including 777 valid samples (with a mean age of 71.81 ± 8.36 years), of which 382 cases (49.2%) were women. The level of healthy fitness was measured using the HFMS V1.0. The Cronbach’s alpha coefficient, split-half reliability, test-retest reliability, convergent and discriminant validity, exploratory factor and confirmatory factor were calculated for assessing the reliability and validity of HFMS V1.0.

Results

HFMS V1.0 consists of 8 dimensions and 38 items. The scale had acceptable reliability (Cronbach’s alpha = 0.920, split-half = 0.946, test-retest = 0.878). Exploratory factor analysis showed KMO value =0.927, and uncovered 10 factors with the cumulative contribution rate of 65.71% and all factor loads over 0.40. The item distribution was consistent with the initial expectation of the scale. The confirmatory factor analysis indicated good fit: CMIN/DF = 2.796, RMSEA = 0.048, IFI =0.914, TLI = 0.902, CFI = 0.913.

Conclusion

HFMS V1.0 was shown to have acceptable reliability and validity indices for this sample. Collectively, HFMS V1.0 is reliable and efficient to measure the healthy fitness of elderly people. It is recommended to use it among the elderly in other Chinese cities in the future to ensure uniformity and objectivity. This scale can be carried out to evaluate of the effectiveness of public health measures in improving the healthy fitness level of the elderly and optimizing public health policies.

Multifaceted Demands of Work and Their Associations with Cognitive Functioning: Findings From the Health and Retirement Study

OBJECTIVES

The present study examines the associations among mental, social, and physical demands of work with cognitive functioning among older adults in the United States.

METHODS

Data from 3,176 respondents in the Health and Retirement Study were analyzed using growth curve modeling (2004-2014). The study investigated differences by gender, race, ethnicity, and education.

RESULTS

Higher mental and social demands of work were associated with higher levels of initial cognitive functioning, but not significantly associated with slower cognitive decline over time. Physical demands of work were negatively associated with initial cognitive functioning and also marginally associated with a slower rate of decline in cognitive functioning going into older adulthood. In stratified analyses, results varied by sociodemographic characteristics.

DISCUSSION

The results partially support the environmental complexity hypothesis and the productive aging framework in that higher mental and social demands and lower physical demands relate to better cognitive functioning at baseline, with the differences appearing stable throughout older adulthood. The stratified results shed light on addressing disparities in cognitive aging and work environments.

[Establishment of the norms of Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) for Chinese urban elderly]

OBJECTIVE

To establish the norms of Healthy Fitness Measurement Scale Version 1.0 (HFMS V1.0) for Chinese urban elderly.

OBJECTIVE

Using a multistage stratified sampling method, we conducted a large- scale epidemiological investigation among 5782 urban elderly residents sampled from Guangzhou (south China), Hefei (East China), Tianjin (north China), Shenyang (northeast China), Luzhou (southwest China) and Lanzhou (northwest China). The mean, percentile and threshold norms were established based on the characteristics of HFMS V1.0 scores for Chinese urban elderly.

OBJECTIVE

The mean and percentile norms of total, physical, mental and social healthy fitness of Chinese urban elderly were established according to gender and different age groups (60-64, 65-69, 70-74, 75-79, and ≥80 years). The threshold norms of HFMS V1.0 were divided into 5 states, namely very low, low, moderate, high and very high states according to the Mean±SD and Mean±0.5SD of the converted scores.

OBJECTIVE

The established norms of Healthy Fitness Measurement Scale (HFMS V1.0) for Chinese urban elderly provide evaluation criteria for Chinese elderly healthy fitness level and facilitate exploration of healthy fitness status and its influencing factors in Chinese urban elderly.

Healthy retirement begins at school: educational differences in the health outcomes of early transitions into retirement

The literature on socio-economic variations in the association between retirement timing and health is inconclusive and largely limited to the moderating role of occupation. By selecting the sample case of Mexico where a sizeable number of older adults have no or very little formal education, this study allows the moderating role of education to be tested properly. Drawing on panel data for 2,430 individuals age 50 and over from the Mexican Health and Aging Study (MHAS) and combining propensity score matching models with fixed-effects regressions, this article investigates differences in the health effects of retirement timing between older adults with varying years of education. Subjective health is measured using a self-reported assessment of respondents' overall health and physical health as a reverse count of doctor-diagnosed chronic diseases. The results indicate that early transitions into retirement are associated with worse health outcomes, but education fully compensates for the detrimental association with subjective and physical health, while adjusting for baseline health, demographics and socio-economic characteristics. In conclusion, formal education during childhood and adolescence is associated with a long-term protective effect on health. It attenuates negative health consequences of early retirement transitions. Policies and programmes promoting healthy and active ageing would benefit from considering the influence of formal education in shaping older adults' health after the transition into retirement.

Older adults’ accounts of the relationships between retirement timing and health: a descriptive qualitative analysis in Chile

Retirement timing can have important health implications. Little is known, however, about older adults’ views on this issue and whether they consider it better to retire later, earlier, on time or anytime. This knowledge gap about older adults’ views is particularly true outside North America and Europe. This qualitative study aims to examine older Chileans’ ideas about the relationship between retirement timing and health and to explore gender and class patterns in qualitative themes identified, knowledge which may strengthen quantitative population-based approaches. Framework analysis was conducted on qualitative accounts from a purposive, non-random sample of 40 older Chileans in six focus groups, stratified by gender and class as marked by lifetime occupation. Transcriptions were coded by two independent reviewers (inter-coder reliability = 81%) according to four deductive categories of retirement timing as well as inductive coding of emergent themes. The content and sequence of codes were visually represented in MAXQDA's document portraits and illustrated with descriptive quotes. Results indicate that participants’ views about when to retire in order to maximise health did not highlight retirement age or timing (later, earlier, on time, anytime). Instead, these older Chileans emphasised that the optimal retirement age depends on other conditions, such as employment quality, retirement income and gender. These views were patterned: lower occupational-class participants emphasised income and job hazards, higher-class males emphasised job satisfaction and higher-class females emphasised gendered patterns. Women and lower-class participants were relatively more favourable to earlier retirements than men and higher-class participants. Overall, qualitative analyses of lay perspectives from understudied country contexts complement and extend population-based models focused on timing or retirement age, suggest specific characteristics of retirement transitions that may moderate health consequences, and highlight class and gender differences in views of retirement timing. More research is needed using mixed-methods approaches and leveraging both purposive and random samples.

Productive Activities and Risk of Cognitive Impairment and Depression: Does the Association Vary by Gender?

We examine how labor together with social participation protects against cognitive impairment and depression, with a focus on gender differences. Data are drawn from four waves of the Korean Longitudinal Study of Aging (2006-2012). Both paid work and unpaid work are considered labor participation. Social participation includes the frequency of participation in formal social institutions, religious groups, grandparenting, and interactions with family and friends. Using growth curve models, we find that social and labor participation are independently associated with outcomes and effects vary by gender. Religious group activity was beneficial only for women, whereas inability to work was detrimental for men only. Informal social gatherings and labor participation, paid or unpaid, were beneficial for both genders. Findings on gender differences highlight how social identities can shape social roles and confine activity space, and productive engagement, affecting outcomes for mental health in later life.

Prevalence, clustering and combined effects of lifestyle behaviours and their association with health after retirement age in a prospective cohort study, the Nord-Trøndelag Health Study, Norway

Background

Lifestyle behaviours are potential risk factors for disease and mortality, but less is known about the association with health in retirement age. The aim of this paper was to study the prevalence, clustering and combined effects of lifestyle behaviours and their association with health outcomes in the first decade after retirement in a Norwegian cohort.

Methods

Participants were 55–64-year-olds at baseline in the Nord-Trøndelag Health Survey 2 (HUNT2, 1995–97) who also participated in HUNT3 (2006–08). Logistic regression analyses were used to investigate the association of daily smoking, physical inactivity, risky alcohol consumption, disturbed sleep duration, excessive sitting time and low social participation before retirement with self-rated health (n = 4022), life satisfaction (n = 5134), anxiety (n = 4461) and depression (n = 5083) after retirement, 11 years later.

Results

Low social participation and physical inactivity were the most prevalent lifestyle behaviours (41.1 and 40.6%). Risky alcohol consumption and disturbed sleep were the lifestyle behaviours most strongly associated with poor self-rated health, poor life satisfaction and anxiety after retirement (OR’s = 1.39–1.92). Physical inactivity was additionally associated with depression (OR = 1.44 (1.12–1.85)). Physical inactivity had the largest population attributable fractions for reducing poor self-rated health and depression (14.9 and 8.8%). An increasing number of lifestyle risk behaviours incrementally increased the risk for the adverse health outcomes.

Conclusions

Risky alcohol consumption and disturbed sleep duration were most strongly associated with poor health outcomes after retirement age. On a population level, increased physical activity before retirement had the largest potential for reducing adverse health outcomes after retirement age.

Longitudinal association between lifetime workforce participation and risk of self-reported cognitive decline in community-dwelling older adults

BACKGROUND

Although many governments are promoting workforce participation (WP) by older people, evidence of WP's effects on active aging is inadequate. We examined whether there is a gender-specific beneficial effect of lifetime WP from adulthood though old age against self-reported cognitive decline (CD) among community-dwelling older adults.

METHODS

We used data from a community-based prospective study of 2,422 men and 2,852 women aged ≥65 with neither poor cognition nor disability in basic activities of daily living at baseline. Self-reported CD was measured using the Cognitive Performance Scale. Lifetime WP evaluated the presence or absence of WP at baseline, the longest-held occupation, and lifetime working years (total working years throughout lifetime). Generalized estimating equations of the multivariable Poisson regression model were applied to evaluate a cumulative incidence ratio (CIR) for self-reported CD and a 95% confidence interval (CI), controlled for age, education, self-perceived economic status, chronic medical conditions, smoking history, physical activity, depression, and instrumental activities of daily living. To examine any gender-specific association, stratified analyses by gender were performed.

RESULTS

The 33-month cumulative incidence of self-reported CD was 15.7% in men and 14.4% in women. After covariate adjustments and mutual adjustment for three items of lifetime WP, men who had their longest held job in a white-collar occupation reported significantly decreased self-reported CD compared to men engaged in blue-collar jobs (CIR 0.72; 95% CI, 0.57-0.91), and women had a significant dose-response relationship between longer lifetime working years and less decline in subjective cognitive functioning (P for trend <0.029). Among both genders, WP at baseline was not associated with self-reported CD.

CONCLUSIONS

Our results suggest that lifetime WP, especially lifetime principal occupation in men and lifetime working years in women, may play a more prominent role in preventing self-reported CD than later-life WP.

Institutional and Individual Factors Affecting Health and Employment for Low-Income Women With Chronic Health Conditions

OBJECTIVES

This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities.

METHODS

The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis.

RESULTS

The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health.

DISCUSSION

Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.

Productive Activity Patterns and Functional Health: A Comparison of Urban and Rural Chinese Older Adults

This study examines the association between productive activity patterns and functional health trajectories of Chinese older adults and whether this association varies by urban/rural residence. Using three waves of the China Health and Retirement Longitudinal Study from a sample of 7,503 older adults, we first performed latent class analysis (LCA) to identify productive activity patterns based on four activities (work, caregiving, informal help, and formal volunteering). Next, multilevel regression analyses were conducted to assess the association between the identified productive activity patterns and functional health trajectories among older adults. Four productive activity patterns are identified from LCA: nonengagers, working-caregivers, workers, and helpers. We find that participation in productive activities is associated with slower functional health decline. The moderation effects of urban/rural differences are prominent across identified groups. Our findings highlight the importance of the urban/rural context in understanding productive aging and its health consequences among Chinese older adults.

Older adults’ integration in the labour market: a global view

What governs labour force participation in later life and why is it so different across countries? Health and labour force participation in older ages are not strongly linked, but we observe a large variation across countries in old-age labour force participation. This points to the important role of country-specific regulations governing pension receipt and old-age labour force participation. In addition to the statutory eligibility age for a pension, such country-specific regulations include: earnings tests that limit the amount of earnings when pension benefits are received; the amount of benefit deductions for early retirement; the availability of part-time pensions before normal retirement; special regulations that permit early retirement for certain population groups; and either subsidies or extra costs for employers if they keep older employees in their labour force. This paper asks two questions: Can we link a relatively low labour force participation at ages 60–64 to country-specific regulations that make early retirement attractive? and Can we link a relatively high labour force participation at ages 65–74 to country-specific regulations that make late retirement attractive? To answer these questions, we compared the experiences in a set of developed countries around the world in order to understand better the impact of country-specific rules and laws on work and retirement behaviour at older ages and, by consequence, on the financial sustainability of pension systems.

Impact of transition in work status and social participation on cognitive performance among elderly in India

Introduction

Transition to the oldage marks a change in work and social participation. Socio-economic and physical conditions arising from this change pose a risk for cognitive outcomes among the elderly. Gender shows different pathways to deal with the pattern of participation and to maintain cognitive health. In India, work participation in the oldage is an outcome of financial deprivations and lack of support. At the same time, alterations in social interactions can induce stress and precipitate cognitive decline in oldage. A dearth of studies in this domain motivates us to estimate the effect of change in work and social participation on cognitive performance of the elderly in the Indian context.

Methods

The study has used the cross-sectional data on 5212 elderly from the World Health Organization’s Study on global AGeing and adult health (Wave 1) (2007–08) in India. A composite score for cognition was generated. Interaction between gender, work status and social participation with respect to cognition was performed using multivariate linear regression. A linear prediction of the cognitive scores across all levels of social participation was post-estimated thereafter.

Results

The study found that the elderly who were ‘presently working’ and showed ‘more’ social participation had a higher mean score for cognitive performance than their counterparts. Results of regression did not indicate any gender interaction with work or social participation. Participation in social activities ‘sometimes’ by those who were ‘retired’ or ‘presently working’ showed a positive and significant co-efficient with cognition among respondents. The post-estimated values for cognition specified that ‘retired’ and ‘presently working’ elderly had higher cognition scores. In the age group of 60–69 years, cognition scores were higher for those who were ‘retired’ and did ‘more’ social participation as compared to the other elderly.

Conclusion

Cognitive aging is attenuated by higher participation in work and social activities. Adequate financial schemes or the pension system can protect the elderly from developing further stress. Retirement at an appropriate age, along with a reasonable amount of social participation, is a boon for cognitive wellbeing. Hence, building more support can contain the detrimental effect of participation restriction on cognitive outcome among elderly.

Electronic supplementary material

The online version of this article (10.1186/s12877-019-1261-5) contains supplementary material, which is available to authorized users.

Working Longer May Be Good Public Policy, But It Is Not Necessarily Good for Older People

Older people are facing a changed set of expectations regarding work and retirement. Until quite recently early retirement was being encouraged. Today's older workers, however, are contemplating longer working lives amid policy concerns about the costs of social welfare associated with an aging population. While working longer is, almost universally, being promoted as a social and individual good this article argues that this policy shift is unlikely to change the situation of many older workers who would have needed to continue working anyway. It also argues that the emphasis on prolonged employment undervalues engagement in activities beyond employment. As well, it argues that the emphasis on prolonging employment neglects to account for the attendant risks for many of continuing to work or having to seek work and the potential health- and well-being-enhancing effects of retirement.

Retirement Sequences of Older Americans: Moderately Destandardized and Highly Stratified Across Gender, Class, and Race

Purpose of the Study

A destandardization of labor-force patterns revolving around retirement has been observed in recent literature. It is unclear, however, to which degree and of which kind. This study looked at sequences rather than individual statuses or transitions and argued that differentiating older Americans' retirement sequences by type, order, and timing and considering gender, class, and race differences yields a less destandardized picture.

Design and Methods

Sequence analysis was employed to analyze panel data from the Health and Retirement Study (HRS) for 7,881 individuals observed 6 consecutive times between ages 60-61 and 70-71.

Results

As expected, types of retirement sequences were identified that cannot be subsumed under the conventional model of complete retirement from full-time employment around age 65. However, these retirement sequences were not entirely destandardized, as some irreversibility and age-grading persisted. Further, the degree of destandardization varied along gender, class, and race. Unconventional sequences were archetypal for middle-level educated individuals and Blacks. Also, sequences for women and individuals with lower education showed more unemployment and part-time jobs, and less age-grading.

Implications

A sequence-analytic approach that models group differences uncovers misjudgments about the degree of destandardization of retirement sequences. When a continuous process is represented as individual transitions, the overall pattern of retirement sequences gets lost and appears destandardized. These patterns get further complicated by differences in social structures by gender, class, and race in ways that seem to reproduce advantages that men, more highly educated individuals, and Whites enjoy in numerous areas over the life course.

Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers

INTRODUCTION

In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group.

OBJECTIVES

This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers.

METHODS

More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated.

RESULTS

The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (β=0.468) and perceptions of supervisor support and social support (β=0.710). The perception of both parameters is associated with stress outcomes (β=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001).

CONCLUSIONS

The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.

Job strain and cognitive change: the Baltimore Epidemiologic Catchment Area follow-up study

OBJECTIVES

To investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study.

METHODS

The sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993-1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004-2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition.

RESULTS

Participants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: -0.24, 95% CI -0.36 to -0.11; verbal memory scores: -0.26, 95% CI -0.44 to -0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors.

CONCLUSIONS

Findings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.

Health, education and employment status of Europeans aged 60 to 69 years: results from SHARE Survey

The objective of this study was to identify health and education related predictors of employment/self-employment in the age between 60 and 69 yr in Europe. Data were obtained from Survey of Health, Ageing and Retirement in Europe (SHARE) study-Wave 6. Our final sample (n=13,447) was retrieved from 16 European Union member states, Switzerland and Israel. We used logistic regression model including education level, physical and mental health parameters to predict employment/self-employment vs. retired. Employment/self-employment was associated with higher education status, increased risk for depression, and obesity, but with decreased risk for chronic diseases, loneliness and limitations in daily life activities. Age-appropriate working conditions, part-time options, and enhanced job characteristics may contribute to maintain a good health status and prevent negative aspects of work that can induce the risk for stress and depression.

Employment and Life Satisfaction Among Middle- and Old-Aged Adults in China

The population in China has been aging rapidly over the past two decades, raising concerns about how to meet the health and long-term care needs of the growing older adult population. The productive aging framework has been applied to promote the active roles that older adults can play in society and to improve physical and psychological well-being. Employment, as an essential form of productive aging, is central to personal control, self-identify, economic resources, and social connectedness. However, there is no clear role or accommodation for older workers in China due to the mandatory retirement policy and traditional culture of gender roles. Using the World Health Organization (WHO) Study on Global Aging and Adult Health (SAGE) Wave 1 data, we examined the relationship between employment and life satisfaction in middle- and old-aged Chinese. Multiple regression analyses indicated that employment and certain work characteristics were positively related to life satisfaction in both the total and male samples. Overall, rural residents had higher levels of satisfaction than urban residents after equalizing socioeconomic resources and health. Policy and practice implications are discussed on how to improve life satisfaction through employment and how to address gender and residency gaps.

Health conditions and unmet needs for assistance to perform activities of daily living among older adults with dementia in Chile

OBJECTIVE

This study aims to address gaps in health conditions and unmet needs in daily activities between people with dementia (PWD) and without dementia in a developing country and to identify the variables associated with unmet needs among PWD to guide practitioners and policymakers in dealing with an increased burden of dementia.

METHODS

Nationally representative data on 4655 Chileans age 60 and over were used to compare health conditions and unmet needs in daily life activities between individuals with (N = 455, 9.6%) and without dementia. Regression analysis was conducted to identify the variables associated with unmet needs among PWD.

RESULTS

Overall, PWD had worse health and needed greater assistance in performing daily activities than people without dementia. Among PWD, being male was associated with more unmet needs, in both activities of daily living (ADL) and instrumental ADL. Lower educational level and fewer caregivers were associated with more unmet needs for ADL, while inferior functional ability was associated with more unmet needs for instrumental ADL.

CONCLUSIONS

The results from this study call for action by practitioners and policymakers to foster caregiver training, increase supportive services, and advance care planning for PWD.

From Snapshots to Movies: The Association Between Retirement Sequences and Aging Trajectories in Limitations to Perform Activities of Daily Living

OBJECTIVE

This study analyzes the dynamic association between retirement sequences and activities of daily living (ADLs) trajectories between ages 60 and 70.

METHOD

Retirement sequences previously established for 7,880 older Americans from the Health and Retirement Study were used in hierarchical linear and propensity score full matching models, analyzing their association with ADL trajectories.

RESULTS

Sequences of partial retirement from full- or part-time jobs showed higher baseline and slower decline in ADL than sequences characterized by early labor force disengagement.

DISCUSSION

The conventional model in which people completely retire from a full-time job at normative ages and the widely promoted new conventional model of late retirement are both associated with better functioning than early labor force disengagement. But unconventional models, where older adults keep partially engaged with the labor force are also significantly associated with better functioning. These findings call attention to more research on potential avenues to simultaneously promote productive engagement and health later in life.

Community activities predict disability and mortality in community-dwelling older adults

AIM

With aging, it is important to maintain older community dwellers' regular engagement with familiar community activities (CA) engaged in close to home to protect them from frailty. Thus, the present study aimed to examine whether CA items or CA score were associated with mortality or the need for care under the new long-term care insurance service requirements over 3 years among community-dwelling older Japanese adults.

METHODS

We analyzed cohort data for older adults from a prospective cohort study in Kami town, Japan. The response rate to the self-reported questionnaire was 94.3% (n = 5094), and we followed these participants for 3 years. Our final sample comprised 5076 older adults. Missing data were filled in using multiple imputation. We used seven items to assess CA: (i) volunteer activity; (ii) regional activity related to the neighborhood; (iii) visiting friends; (iv) hobbies or favorite lessons; (v) earning an income; (vi) farm work and growing vegetables; and (vii) shopping daily by oneself. The Kihon Checklist and new long-term care insurance service certifications were used as the frailty screening and disability indices, respectively.

RESULTS

During the follow-up survey, 705 participants obtained new long-term care insurance service certifications and 262 died. Using the receiver operating characteristic curve, the desirable cut-off of the CA score to predict disability and mortality was at least two items for all elderly age groups in rural areas.

CONCLUSIONS

CA items and CA score could predict disability and mortality in community-dwelling older adults in Japanese rural areas. Therefore, it is recommended that older adults from all age groups participate in CA. Geriatr Gerontol Int 2018; 18: 1114-1124.

Conceptualizing Productive Engagement in a System Dynamics Framework

Gerontologists have argued that the growing human capital of the aging population can be better marshaled as a resource for families, communities, and society at large. Additionally, this active, purposeful engagement can produce positive outcomes for older adults themselves. In this manuscript, we propose that existing conceptual frameworks articulating antecedents and outcomes of productive engagement, including working, volunteering, and caregiving can be improved using a system dynamics (SD) approach. Through a series of five unstructured group model-building sessions, experts from gerontology and systems science developed a qualitative SD model of the productive engagement of older adults. The model illustrates the reciprocal and dynamic nature of the stocks of human capital of older adults, social capital of older adults, and family resources; the engagement of older adults in productive activities; and the social and organizational variables that affect the flow and depletion of these stocks. Given this is the first attempt to develop a SD model for productive engagement in later life, the model is preliminary and heuristic. However, it offers a new approach to advancing theory and research on productive engagement in later life. Further, it can guide the development of mathematical models to estimate the effects of changes in any part of this system.

Dementia in the workplace case study research: understanding the experiences of individuals, colleagues and managers

This article reports case study research which addresses the gap in knowledge about dementia in the workplace. Receiving a diagnosis of dementia whilst still in employment may have negative consequences for a person's identity, further compounded by loss of employment. This study is the first to explore the employment-related experiences of people with dementia and their employers to determine the potential for continued employment post-diagnosis. Sixteen case studies centred on a person with dementia who was still in employment or had left in the previous 18 months. Each involved interviews with the person with dementia, a family member and a workplace representative. This triangulation of the data promoted rigour, allowing the experiences to be viewed through a variety of lenses to build a clear picture of each situation. Thematic analysis was carried out and three themes were developed: (a) dementia as experienced in the workplace; (b) work keeps me well; and (c) wider impact of dementia in the workplace. These findings have the potential to initiate changes to policy and practice related to supporting employees with dementia. The implications of this research are multifaceted and need to be considered in terms of the individuals’ wellbeing, organisational support, as well as the wider theoretical, economic and societal consequences of supporting an employee with dementia.

The effects of China's universal two-child policy

In October, 2015, China's one-child policy was replaced by a universal two-child policy. The effects of the new policy are inevitably speculative, but predictions can be made based on recent trends. The population increase will be relatively small, peaking at 1·45 billion in 2029 (compared with a peak of 1·4 billion in 2023 if the one-child policy continued). The new policy will allow almost all Chinese people to have their preferred number of children. The benefits of the new policy include: a large reduction in abortions of unapproved pregnancies, virtual elimination of the problem of unregistered children, and a more normal sex ratio. All of these effects should improve health outcomes. Effects of the new policy on the shrinking workforce and rapid population ageing will not be evident for two decades. In the meantime, more sound policy actions are needed to meet the social, health, and care needs of the elderly population.