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Zaccagni S, Sigsgaard AM, Vrangbaek K, Noermark LP. Who continues to work after retirement age? BMC Public Health 2024; 24:692. [PMID: 38438993 PMCID: PMC10913677 DOI: 10.1186/s12889-024-18161-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 02/20/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Demographic changes in all industrialized countries have led to a keen interest in extending working lives for older workers. To achieve this goal, it is essential to understand the patterns of retirement and specifically what characterizes individuals who continue to work beyond retirement age. Thus, the aim of this paper was to contribute to the international body of empirical knowledge about individuals who continue in the workforce after retirement age. We present evidence from Denmark and examine what characterizes individuals who continue in the workforce after retirement age and investigate the likelihood of continued work after retirement age while controlling for a set of socio-economic and lifestyle factors. METHODS The study population consisted of 5,474 respondents to the Copenhagen Aging and Midlife Biobank (CAMB) 2021 survey, divided into two groups. The first group included subjects (n = 1,293) who stayed longer in the workforce even though they had the possibility to retire. The second group consisted of subjects who had retired full-time at the time of the survey (n = 4,181). Survey data was linked to register data to provide a broader dataset. In order to investigate the heterogeneity between the two groups in terms of important socio-economic, work-related and health-related variables, t-test, Mann-Whitney U (Wilcoxon Rank) test, and chi-square tests were employed. Further, to examine the probability of an individual working after retirement age a logit model with step-wise inclusion was utilized. RESULTS Overall, individuals who continue to work even though they could retire tend to be wealthier, healthier, and males compared to individuals who are retired full-time. Further, there are more older workers who have partners and are co-habitants than retirees. The likelihood of continuing in the workforce past retirement age is affected by several work-related factors as well as life-style factors. The likelihood of working past retirement age decreases by years spent in the workforce (marginal effect of -0.003), if you have a partner (-0.080) and if your partner is outside of the workforce (marginal effect of -0.106). The likelihood increases by health (marginal effect of -0.044 of moving from excellent/very good health to good health or to fair/poor health, physical working capability (marginal effect of -0.083 of moving from no/some problems to severe problems or cannot work at all) and income (marginal effect of 0.083 from moving from the lowest income-quantile to higher quantiles). CONCLUSION These results are in line with the previous literature and suggest the importance of designing retirement policies that tailor the transition toward retirement according to specific characteristics of both the individual and the segment of occupation.
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Affiliation(s)
- Sarah Zaccagni
- Department of Economics & Business Economics, Aarhus University, Aarhus, Denmark
| | - Anna Munk Sigsgaard
- Department of Prevention, Health Promotion and Community Care, Steno Diabetes Center Copenhagen, Herlev, Denmark
| | - Karsten Vrangbaek
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Fujii K, Lee S, Katayama O, Makino K, Harada K, Tomida K, Morikawa M, Yamaguchi R, Nishijima C, Misu Y, Shimada H. Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study. Int Arch Occup Environ Health 2023; 96:1225-1234. [PMID: 37486376 DOI: 10.1007/s00420-023-02000-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/12/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE This prospective cohort study investigates the relationship between the onset of disability and employment status. METHODS We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status. RESULTS The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status. CONCLUSIONS Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.
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Affiliation(s)
- Kazuya Fujii
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan.
| | - Sangyoon Lee
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Osamu Katayama
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Keitaro Makino
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
- Japan Society for the Promotion of Science, Chiyoda-Ku, Tokyo, Japan
| | - Kenji Harada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Kouki Tomida
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Masanori Morikawa
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Ryo Yamaguchi
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Chiharu Nishijima
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Yuka Misu
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
| | - Hiroyuki Shimada
- Department of Preventive Gerontology, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, 7-430, Morioka-Cho, Obu, Aichi, 474-8511, Japan
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Shimizu N, Ide K, Kondo K. Association between diversity levels of member composition in group activities of older adults and the occurrence of need for care: the JAGES 2013-2019 longitudinal study. BMC Geriatr 2023; 23:579. [PMID: 37730556 PMCID: PMC10510208 DOI: 10.1186/s12877-023-04261-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 08/28/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Participating in groups with diverse members is associated with improved health among older adults. The study examined the relationship between diversity of group members and needed support or long-term care. METHODS We conducted a longitudinal study for the Japan Gerontological Evaluation Study with 61,281 participants aged ≥ 65 years who were surveyed in 2013 and followed-up for six years. We assessed three dimensions of the diversity of the participating members (sex, age, and region of residence). We then graded the diversity level into four categories: level 0 (not in any group), level 1 (in a group without diversity or in a group with diversity in one of the three factors), level 2 (in a group with diversity in two of the three factors), or level 3 (in a group with diversity across all factors). We adjusted for 12 covariates using Cox hazard survival analysis models with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated for the association between group members' diversity levels and needed support or long-term care. The same study was conducted when stratified by employment status at baseline. RESULTS Participants in social participation groups with more diverse group members had a lower incidence of needed support or long-term care as compared to their counterparts. Compared to those with no participation group, HR decreased by 14% to 24% with increasing levels of diversity. The HR for the level of care needed for participants in the social participation group with high residential diversity was 0.89 (95% CI: 0.84-0.94). For participants who were currently unemployed, HR reductions ranged from 16%-28% with increasing levels of diversity compared to the non-participating group. No association was found for employed participants. CONCLUSIONS The reason the HRs of Japanese elderly people certified as needing support or care are lower when the diversity of participating groups is higher could be owing to the presence of a variety of people and the diversification of social networks, which facilitates the building of bridging social relational capital. Public health policies that encourage participation in diverse organizations will be important in the future.
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Affiliation(s)
- Nao Shimizu
- Department of Physical Therapy, Faculty of Health Sciences, Ryotokuji University, 5-8-1 Akemi, Urayasu-Shi, Chiba, 279-8567, Japan.
- Department of Public Health, Graduate School of Medicine, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan.
| | - Kazushige Ide
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Department of Community General Support, Hasegawa Hospital, Yachimata, Chiba, 289-1113, Japan
| | - Katsunori Kondo
- Center for Preventive Medical Sciences, Chiba University, Yayoi-Cho, Inage, Chiba, 263-8522, Japan
- Center for Gerontology and Social Science, Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka-Cho, Obu, Aichi, 474-8511, Japan
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Development and Evaluation of Neighborhood Care Volunteer Training Programs-Preparing for Older Adult Community Care in Taiwan. THE JOURNAL OF NURSING RESEARCH : JNR 2023; 31:e257. [PMID: 36692836 DOI: 10.1097/jnr.0000000000000539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND The prevalence of chronic diseases and functional disorders is projected to escalate as the older adult population increases. Thus, the demand for and burdens of long-term care are increasing. Training middle-aged and older volunteers at the community level will enhance health promotion and disease prevention in communities. PURPOSE In this study, multilevel volunteer training programs and related implementation methods were designed for neighborhood caregivers. METHODS This study was divided into two phases. In Phase 1, an expert review was conducted using the modified Delphi method to congregate expert opinions into an interdisciplinary consensus and establish the content and methods of implementation of the multilevel training program. In Phase 2, the training programs were implemented and evaluated. RESULTS In Phase 1, 17 experts in geriatric and long-term care were enrolled in the Delphi surveys. Consensus was defined as at least 80% agreement. These experts devised volunteer training programs for neighborhood caregivers at three levels: basic caregiver training, advanced caregiver training, and volunteer caregiver instructor training. The curriculum focused on fulfilling the health demands of neighborhood care; adopted disability-prevention and disability-delaying healthcare as the basic framework; and referred to the attention, relevance, confidence, and satisfaction model of motivational design. This model of motivational design drew on the attributes of volunteers and the current state of care programs, including interest, program difficulty, and feasibility of future services. In Phase 2, 50 community middle-aged and older volunteers enrolled in the training programs and, after completing the program, were asked to evaluate their satisfaction with the program content and program effectiveness. A high level of satisfaction was reported across all three levels. CONCLUSIONS/IMPLICATIONS FOR PRACTICE The training programs achieved satisfactory consistency and convergence and were well received by the volunteer trainees. These programs may be referenced in the development of future training programs and the creation of a model of community healthcare services. The curriculum was designed from the learners' perspective with direct healthcare applications. A progressive multilevel set of neighborhood care volunteer training programs was offered to cultivate community volunteers.
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Chowdhury P, Mohanty I, Singh A, Niyonsenga T. Informal sector employment and the health outcomes of older workers in India. PLoS One 2023; 18:e0266576. [PMID: 36812213 PMCID: PMC9946227 DOI: 10.1371/journal.pone.0266576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
A large proportion of the older population in India constitutes an undeniable share of workforce after the retirement age. This stresses the need to understand the implications of working at older ages on health outcomes. The main objective of this study is to examine the variations in health outcomes by formal/informal sector of employment of older workers using the first wave of the Longitudinal Ageing Study in India. Using binary logistic regression models, the results of this study affirm that type of work does play a significant role in determining health outcomes even after controlling socio-economic, demographic, life-style behaviour, childhood health and work characteristics. The risk of Poor Cognitive Functioning (PCF) is high among informal workers, while formal workers suffer greatly from Chronic Health Conditions (CHC) and Functional Limitations (FL). Moreover, the risk of PCF and/or FL among formal workers increases with the increase in risk of CHC. Therefore, the present research study underscores the relevance of policies focusing on providing health and healthcare benefits by respective economic activity and socio-economic position of older workers.
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Affiliation(s)
- Poulomi Chowdhury
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
- * E-mail:
| | - Itismita Mohanty
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
| | - Akansha Singh
- Department of Anthropology, Durham Research Methods Centre, Durham University, Durham, United Kingdom
| | - Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Canberra, Australian Capital Territory, Australia
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Murayama H, Takase M, Watanabe S, Sugiura K, Nakamoto I, Fujiwara Y. Employment in old age and all-cause mortality: A systematic review. Geriatr Gerontol Int 2022; 22:705-714. [PMID: 35924632 DOI: 10.1111/ggi.14449] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 05/17/2022] [Accepted: 07/13/2022] [Indexed: 11/28/2022]
Abstract
Social participation promotes and maintains the health of older adults. Working is a type of social participation; however, the effect of employment in old age on health outcomes has not been established. This study aimed to review the relationship between employment in old age (≥60 years) and all-cause mortality. For this systematic review, a computerized search was performed using PubMed, CINAHL and PsycINFO for prospective studies published through June 2020. The observational studies were extracted according to the study participants, indicators, follow-up period, statistical approach and main results. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Of the 37 832 records identified, 14 studies were included in the systematic review based on the inclusion and exclusion criteria. Eight studies were derived from Asian countries (four from Japan, two from Taiwan and one from Thailand and South Korea), three were from the United States, two were from Israel and one was from Brazil. The baseline data of 13 studies were collected before 2000. Thirteen of the 14 studies reported any association between employment in later life and a lower risk of mortality. Four studies examined the sex-related differences in the effect of later-life employment on all-cause mortality, but the association was controversial. Overall, we revealed that working in old age would lower mortality risk. Although more findings based on recent data are required, this study indicates that working later in life is beneficial for promoting and maintaining health. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Hiroshi Murayama
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Mai Takase
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Saya Watanabe
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.,Faculty of Human Sciences, Bunkyo University, Saitama, Japan
| | - Keiko Sugiura
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Isuzu Nakamoto
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Yoshinori Fujiwara
- Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Complex Multimorbidity and Working beyond Retirement Age in Japan: A Prospective Propensity-Matched Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116553. [PMID: 35682136 PMCID: PMC9179975 DOI: 10.3390/ijerph19116553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/11/2022] [Accepted: 05/23/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND With the aging of populations worldwide, the extension of people's working lives has become a crucial policy issue. The aim of this study is to assess the impact of complex multimorbidity (CMM) as a predictor of working status among retirement-aged adults in Japan. METHODS Using a nationwide longitudinal cohort study of people aged over 65 who were free of documented disability at baseline, we matched individuals with respect to their propensity to develop CMM. The primary outcome of the study was working status after the six-year follow-up. RESULTS Among 5613 older adults (mean age: 74.2 years) included in the study, 726 had CMM and 2211 were still working at the end of the follow-up. In propensity-matched analyses, the employment rate was 6.4% higher in the CMM-free group at the end of the six-year follow-up compared to the CMM group (725 pairs; 29.5% vs. 35.9%; p = 0.012). Logistic regression analysis showed that CMM prevented older people from continuing to work beyond retirement age and was a more important factor than socioeconomic factors (income or educational attainment) or psychological factors (depressive symptoms or purpose in life). CONCLUSIONS Our study found that CMM has an adverse impact on the employment rate of older adults in Japan. This finding suggests that providing appropriate support to CMM patients may extend their working lives.
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The frequency of job participation and well-being of older people in Japan: Results from JAGES study. Arch Gerontol Geriatr 2022; 102:104720. [DOI: 10.1016/j.archger.2022.104720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 05/07/2022] [Indexed: 11/23/2022]
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Baxter S, Blank L, Cantrell A, Goyder E. Is working in later life good for your health? A systematic review of health outcomes resulting from extended working lives. BMC Public Health 2021; 21:1356. [PMID: 34238265 PMCID: PMC8268509 DOI: 10.1186/s12889-021-11423-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 06/23/2021] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Susan Baxter
- School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield, S14DA, UK.
| | - Lindsay Blank
- School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield, S14DA, UK
| | - Anna Cantrell
- School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield, S14DA, UK
| | - Elizabeth Goyder
- School of Health and Related Research, University of Sheffield, Regent Court, Regent Street, Sheffield, S14DA, UK
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Taira K, Ogata S, Kamide K. Comparing the differences in three measures of healthy life expectancy among prefectures in Japan. BMC Res Notes 2020; 13:371. [PMID: 32758291 PMCID: PMC7404923 DOI: 10.1186/s13104-020-05213-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 07/29/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE An ecological study using secondary open data from Japanese government statistics was conducted. The study aimed to verify differences in three measures of healthy life expectancy (HLE); namely, disability-free life expectancy without activity limitation (DFLE-AL), life expectancy with self-perceived health (LE-SH), and disability-free life expectancy without care need (DFLE-CN). RESULTS Each HLE from 47 prefectures in 2010, 2013, and 2016 was extended over time. There were strong Cronbach's coefficient alpha (α) between DFLE-AL and LE-SH (Minimum α; 0.80, Maximum α; 0.90) as well as between LE and DFLE-CN (Minimum α; 0.92, Maximum α; 0.99) in both sexes in every data year. However, the other pairs had weaker associations. In regression analysis with each HLE as a dependent variable and aging rate, mortality, the proportion of unhealthy people as independent variables, the subjective unhealthy rate had significant standardized partial regression coefficients (β) in models with DFLE-AL and LE-SH as dependent variables (Minimum β; - 0.56, Maximum β; - 0.34). Therefore, DFLE-CN tended to differ from the other HLEs. The subjective unhealthy rate had a significant influence on DFLE-AL and LE-SH.
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Affiliation(s)
- Kazuya Taira
- Department of Human Health Science, Graduate School of Medicine, Kyoto University, 53, Shogoinkawara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Soshiro Ogata
- Department of Preventive Medicine and Epidemiology, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan.,Faculty of Nursing, School of Health Science, Fujita Health University, Toyoake, Aichi, Japan
| | - Kei Kamide
- Division of Health Sciences, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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Tomioka K, Kurumatani N, Saeki K. Cross-Sectional Association Between Types of Leisure Activities and Self-rated Health According to Gender and Work Status Among Older Japanese Adults. J Epidemiol 2019; 29:424-431. [PMID: 30318494 PMCID: PMC6776474 DOI: 10.2188/jea.je20180108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Background Participation in leisure activities (LA) is essential for successful aging. Our aim was to investigate the cross-sectional association of types of LA with self-rated health (SRH) by gender and work status. Methods The target population was all residents aged ≥65 years in a municipality (n = 16,010; response rate, 62.5%). We analyzed 4,044 men and 4,617 women without disabilities. LA were categorized into 14 types. SRH was assessed through the SF-8. Excellent or very good SRH was defined as positive SRH. Covariates included age, marital status, education, subjective economic status, body mass index, chronic diseases, alcohol, smoking, walking time, depression, and cognitive functioning. Multiple logistic regressions were used to calculate the odds ratio (OR) and 95% confidence interval (CI) for positive SRH, with non-participation as the reference. Results After adjustment for covariates and mutual adjustment for other LA, participation in the following types of LA was positively associated with positive SRH: sports activities among working men (OR 1.46; 95% CI, 1.07–2.00), non-working men (OR 1.33; 95% CI, 1.04–1.69), and non-working women (OR 1.74; 95% CI, 1.41–2.15); cooking among non-working men (OR 1.65; 95% CI, 1.18–2.33) and non-working women (OR 1.28; 95% CI, 1.03–1.60); musical activities among working men (OR 1.44; 95% CI, 1.01–2.05) and non-working women (OR 1.59; 95% CI, 1.29–1.95); and technology usage only among working men (OR 1.41; 95% CI, 1.01–1.96). In contrast, TV watching was negatively associated with positive SRH among non-working women (OR 0.69; 95% CI, 0.56–0.85). Conclusions Our results suggest that encouraging older adults to participate in types of LA appropriate to their gender and work status might be a key to positive SRH.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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Tomioka K, Kurumatani N, Saeki K. Older Adult Males Who Worked at Small-Sized Workplaces Have an Increased Risk of Decline in Instrumental Activities of Daily Living: A Community-Based Prospective Study. J Epidemiol 2019; 29:407-413. [PMID: 30298862 PMCID: PMC6776476 DOI: 10.2188/jea.je20180113] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 09/19/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND To examine the relationship of working history from early adulthood through old age with instrumental activities of daily living (IADL). METHODS Analyzed participants were 5,857 community-dwelling older Japanese people aged ≥65 years. Using the Tokyo Metropolitan Institute of Gerontology Index of Competence, IADL decline was defined as individuals who had no IADL dependence at baseline but were deemed as dependent in IADL at follow-up. Work history was based on working status at baseline, total working years, and information concerning the longest held job, including occupation, employment pattern, and workplace size (number of employees). We conducted multiple logistic regression analyses and estimated the odds ratios (ORs) for IADL decline with 95% confidence intervals (CIs) by gender. RESULTS At the 33-month follow-up, 428 men (16.6%) and 275 women (8.4%) developed IADL decline. After covariate adjustments, men with unstable employment reported significantly increased IADL decline (OR 1.52; 95% CI, 1.19-1.95) compared to men with stable employment, and men who worked in small workplaces with 1-49 employees had an increased risk for IADL decline (OR 1.53; 95% CI, 1.21-1.93) compared to men in large-sized workplaces with ≥50 employees. After mutual adjustment for all working history items, only the association between small workplaces and IADL decline remained significant in men (OR 1.37; 95% CI, 1.03-1.84). Among women, none of the working history items were associated with IADL decline. CONCLUSION Our results suggest that not only promoting older people's workforce participation, but also providing workers employed at small workplaces with sufficient occupational health services, may be effective in helping men retain IADL in later life.
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Affiliation(s)
- Kimiko Tomioka
- Nara Prefectural Health Research Center, Nara Medical University
| | - Norio Kurumatani
- Nara Prefectural Health Research Center, Nara Medical University
| | - Keigo Saeki
- Nara Prefectural Health Research Center, Nara Medical University
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