Health, lifestyle and employment beyond state-pension age

Why do men extend their employment beyond pensionable age more often than women? a cohort study

Men extend their employment beyond pensionable age more often than women, but the factors that contribute to this sex difference are unknown. This study aimed to examine sex differences in extending employment and the contribution of sociodemographic, work- and health-related factors to these differences. Participants of this prospective cohort study were 4,263 public sector employees from Finland who reached their individual pensionable date between 2014 and 2019 and responded to a survey on work- and non-work-related issues before that date. Extended employment was defined as continuing working for over six months beyond the individual pensionable date. We used mediation analysis to examine the contribution of explanatory factors to the association between sex and extended employment. Of the participants, 29% extended employment beyond the pensionable date. Men had a 1.29-fold (95% confidence interval 1.11–1.49) higher probability of extending employment compared with women. Men had a higher prevalence of factors that increase the likelihood of extended employment than women (such as spouse working full-time, no part-time retirement, low job strain, high work time control, and lack of pain) and this mediated the association of sex with extended employment by up to 83%. In conclusion, men were more likely to extend their employment beyond pensionable age than women. This difference was largely explained by men being more likely to have a full-time working spouse, low job strain, high work time control, no pain, and not being on part-time retirement.

Association of perceived job security and chronic health conditions with retirement in older UK and US workers

Background

The relationship between job insecurity, chronic health conditions (CHCs) and retirement among older workers are likely to differ between countries that have different labor markets and health and social safety nets. To date, there are no epidemiological studies that have prospectively assessed the role of job insecurity in retirement incidence, while accounting for CHC trajectories in two countries with different welfare systems. We investigated the strength of the association between baseline job insecurity and retirement incidence over an 11-year period while accounting for CHC trajectories, among workers 50–55 years of age at baseline in the UK and USA.

Methods

We performed Cox proportional hazards regression analysis, using 2006–2016 data from the Health and Retirement Study (US cohort, n = 570) and English Longitudinal Study on Aging (UK cohort n = 1052).

Results

Job insecurity was associated with retirement after adjusting for CHC trajectories (HR = 0.69, 95% CI = 0.50–0.95) in the UK cohort only. CHC trajectories were associated with retirement in both cohorts; however, this association was attenuated in the US cohort, but remained significant for the medium-increasing trajectory in the UK cohort (HR = 1.41, 95% CI = 1.01–1.97) after adjustment for all covariates. Full adjustment for relevant covariates attenuated the association between job insecurity and retirement indicating that CHCs, social and health factors are contributing mechanistic factors underpinning retirement incidence.

Conclusions

The observed differences in the two cohorts may be driven by macro-level factors operating latently, which may affect the work environment, health outcomes and retirement decisions uniquely in different settings.

"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.

Employment Status Prior to Ischemic Stroke and Weekly Variation of Stroke Onset

OBJECTIVES

To investigate the differences in clinical backgrounds, especially weekly variations of stroke occurrence, between hyper-acute ischemic stroke patients with and without regular employment (RE), as well as the impact of RE on outcome.

MATERIALS AND METHODS

Symptomatic ischemic stroke patients with ≤4.5 h from onset to door were enrolled. First, we divided patients into the RE and non-RE group to analyze differences in clinical characteristics, especially relation between weekly variations of stroke occurrence and RE. Second, we divided the same patients into those with and without favorable outcomes (modified Rankin Scale score of 0 to 2 at 3 months from stroke onset) to analyze the impact of RE on outcomes.

RESULTS

We screened 1,249 consecutive symptomatic ischemic stroke patients and included 377 patients (284 [75%] males; median age, 67 years). Of these patients, 248 (66%) were included in RE group. First, RE was independently associated with occurrence of stroke on Monday in reference to Sunday or a public holiday (OR 2.562, 95% CI 1.004-6.535, p = 0.049). Second, RE (OR 2.888 95% CI 1.378-6.050, p = 0.005) was a factor independently associated with a favorable outcome.

CONCLUSIONS

Patients with RE were more likely to have a hyper-acute ischemic stroke on Monday in reference to Sunday or a public holiday. However, RE before stroke onset appears to have a positive impact on outcome.

The Effect of an Increase of the Retirement Age on the Health, Well-Being, and Labor Force Participation of Older Workers: a Systematic Literature Review

To sustain a viable public pension system, many governments have increased the statutory retirement age and delayed the age of entitlement to public pension benefits. This systematic literature review investigates the empirical evidence on the effects of increasing the retirement age on the health, well-being, and labor force participation of older workers. Optimized and broad search queries were used to search for empirical evidence in four databases: EconLit, PsycINFO, PubMed, and SocINDEX. The systematic literature search was conducted in May 2019. Snowballing was performed on the reference lists of the publications to find additional studies. The quality of the included studies was also examined. The PRISMA guidelines were used to guide this systematic literature review. Nineteen studies were included in this review. Twelve studies estimated the effect of an increase in the statutory retirement age, and seven studies examined working beyond the retirement age. The reported findings were classified into health-related outcomes, well-being, and the effects on labor force participation and the perception of the retirement age. The reported findings regarding health-related outcomes and well-being were not comparable. The increase of the retirement age has increased labor force participation among older workers and has increased the preferred and expected retirement age in the direction of the public pension reform. However, evidence on the effects of an increase of the retirement age on the health and well-being of older workers remains scarce and inconclusive.

A comprehensive assessment of risk factors for falls in middle-aged adults: co-ordinated analyses of cohort studies in four countries

We identified demographic, health and lifestyle factors associated with falls in adults aged 50-64 years from Australia, The Netherlands, Great Britain and Ireland. Nearly all factors were associated with falls, but there were differences between countries and between men and women. Existing falls prevention programs may also benefit middle-aged adults.

INTRODUCTION

Between ages 40-44 and 60-64 years, the annual prevalence of falls triples suggesting that middle age may be a critical life stage for preventive interventions. We aimed to identify demographic, health and lifestyle factors associated with falls in adults aged 50-64 years.

METHODS

Harmonised data were used from four population-based cohort studies based in Australia (Australian Longitudinal Study on Women's Health, n = 10,641, 51-58 years in 2004), Ireland (The Irish Longitudinal Study on Ageing, n = 4663, 40-64 years in 2010), the Netherlands (Longitudinal Ageing Study Amsterdam, n = 862, 55-64 years in 2012-13) and Great Britain (MRC National Survey of Health and Development, n = 2987, 53 years in 1999). Cross-sectional and prospective associations of 42 potential risk factors with self-reported falls in the past year were examined separately by cohort and gender using logistic regression. In the absence of differences between cohorts, estimates were pooled using meta-analysis.

RESULTS

In cross-sectional models, nearly all risk factors were associated with fall risk in at least one cohort. Poor mobility (pooled OR = 1.71, CI = 1.34-2.07) and urinary incontinence (OR range = 1.53-2.09) were consistently associated with falls in all cohorts. Findings from prospective models were consistent. Statistically significant interactions with cohort and sex were found for some of the risk factors.

CONCLUSION

Risk factors known to be associated with falls in older adults were also associated with falls in middle age. Compared with findings from previous studies of older adults, there is a suggestion that specific risk factors, for example musculoskeletal conditions, may be more important in middle age. These findings suggest that available preventive interventions for falls in older adults may also benefit middle-aged adults, but tailoring by age, sex and country is required.

The role of personal characteristics, work environment and context in working beyond retirement: a mixed-methods study

Objective

To investigate the role of personal characteristics, work environment and context in working beyond retirement.

Methods

In the current study, a mixed-methods design was applied including quantitative survey data and semi-structured telephone interviews. Respondents (N = 568) were selected from the Study on Transitions in Employment, Ability and Motivation (STREAM). Personal characteristics, work characteristics and contextual factors were measured using a questionnaire at baseline. Concurrently, qualitative data of 30 persons aged over 65 years were gathered. Logistic regression analyses were used to identify quantitative associations and thematic analyses were used for qualitative purposes.

Results

Quantitative data revealed that being in good physical health (OR = 1.80), developmental proactivity (OR = 1.38), interesting work (OR = 2.02), appreciation (OR = 1.62) and voluntary work (OR = 1.58) were associated with working beyond the statutory retirement age. Additionally, qualitative findings suggested that working beyond retirement was mainly driven by the desire to contribute to society (e.g., mentor younger coworkers), and identified the employers’ willingness to hire an older worker despite existing stereotypes as an important precondition.

Conclusions

Working beyond retirement is influenced by physical health and work characteristics, as well as motivational determinants such as the desire to contribute to society. However, to meet the increasing demands for paid jobs by individuals aged over 65 years, the willingness of employers to actually hire them is crucial. Therefore, recognition and utilization of older workers’ potentials is of great importance.

Retirement ages of senior UK doctors: national surveys of the medical graduates of 1974 and 1977

OBJECTIVE

To report on retirement ages of two cohorts of senior doctors in the latter stages of their careers.

DESIGN

Questionnaires sent in 2014 to all medical graduates of 1974 and 1977.

SETTING

UK.

PARTICIPANTS

3695 UK medical graduates.

MAIN OUTCOME MEASURES

Retirement status by age at the time of the survey and age at retirement if retired. Planned retirement ages and retirement plans if not retired.

RESULTS

Of contactable doctors, 85% responded. 43.7% of all responding doctors had fully retired, 25.9% had 'retired and returned' for some medical work, 18.3% had not retired and were working full-time in medicine, 10.7% had not retired and were working part-time in medicine and 1.4% were either doing non-medical work or did not give details of their employment status. The average actual retirement age (including those who had retired but subsequently returned) was 59.6 years (men 59.9, women 58.9). Psychiatrists (58.3) and general practitioners (GPs) (59.5) retired at a slightly younger age than radiologists (60.4), surgeons (60.1) and hospital specialists (60.0). More GPs (54%) than surgeons (26%) or hospital medical specialists (34%) were fully retired, and there were substantial variations in retirement rates in other specialties. Sixty-three per cent of women GPs were fully retired.

CONCLUSIONS

Gender and specialty differences in retirement ages were apparent and are worthy of qualitative study to establish underlying reasons in those specialties where earlier retirement is more common. There is a general societal expectation that people will retire at increasingly elderly ages; but the doctors in this national study retired relatively young.