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Association of retirement age with mortality: A population-based longitudinal study among older adults in the USA

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Abstract and Figures

Background: Retirement is an important transitional process in later life. Despite a large body of research examining the impacts of health on retirement, questions still remain regarding the association of retirement age with survival. We aimed to examine the association between retirement age and mortality among healthy and unhealthy retirees and to investigate whether sociodemographic factors modified this association. Methods: On the basis of the Health and Retirement Study, 2956 participants who were working at baseline (1992) and completely retired during the follow-up period from 1992 to 2010 were included. Healthy retirees (n=1934) were defined as individuals who self-reported health was not an important reason to retire. The association of retirement age with all-cause mortality was analysed using the Cox model. Sociodemographic effect modifiers of the relation were examined. Results: Over the study period, 234 healthy and 262 unhealthy retirees died. Among healthy retirees, a 1-year older age at retirement was associated with an 11% lower risk of all-cause mortality (95% CI 8% to 15%), independent of a wide range of sociodemographic, lifestyle and health confounders. Similarly, unhealthy retirees (n=1022) had a lower all-cause mortality risk when retiring later (HR 0.91, 95% CI 0.88 to 0.94). None of the sociodemographic factors were found to modify the association of retirement age with all-cause mortality. Conclusions: Early retirement may be a risk factor for mortality and prolonged working life may provide survival benefits among US adults.
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Association of retirement age with mortality:
a population-based longitudinal study among
older adults in the USA
Chenkai Wu,
Michelle C Odden,
Gwenith G Fisher,
Robert S Stawski
Additional material is
published online only. To view
please visit the journal online
School of Biological and
Population Health Sciences,
College of Public Health and
Human Sciences, Oregon State
University, Corvallis, Oregon,
Department of Psychology,
Colorado State University, Fort
Collins, Colorado, USA
School of Social and Human
Health Sciences, College of
Public Health and Human
Sciences, Oregon State
University, Corvallis, Oregon,
Correspondence to
Chenkai Wu, School of
Biological and Population
Health Sciences, College of
Public Health and Human
Sciences, Oregon State
University, 206 Bates Hall,
Corvallis, OR 97331, USA;
Received 15 December 2015
Revised 23 February 2016
Accepted 4 March 2016
To cite: Wu C, Odden MC,
Fisher GG, et al.J Epidemiol
Community Health Published
Online First: [please include
Day Month Year]
Background Retirement is an important transitional
process in later life. Despite a large body of research
examining the impacts of health on retirement, questions
still remain regarding the association of retirement age
with survival. We aimed to examine the association
between retirement age and mortality among healthy
and unhealthy retirees and to investigate whether
sociodemographic factors modied this association.
Methods On the basis of the Health and Retirement
Study, 2956 participants who were working at baseline
(1992) and completely retired during the follow-up
period from 1992 to 2010 were included. Healthy
retirees (n=1934) were dened as individuals who self-
reported health was not an important reason to retire.
The association of retirement age with all-cause
mortality was analysed using the Cox model.
Sociodemographic effect modiers of the relation were
Results Over the study period, 234 healthy and 262
unhealthy retirees died. Among healthy retirees, a 1-year
older age at retirement was associated with an 11%
lower risk of all-cause mortality (95% CI 8% to 15%),
independent of a wide range of sociodemographic,
lifestyle and health confounders. Similarly, unhealthy
retirees (n=1022) had a lower all-cause mortality risk
when retiring later (HR 0.91, 95% CI 0.88 to 0.94).
None of the sociodemographic factors were found to
modify the association of retirement age with all-cause
Conclusions Early retirement may be a risk factor for
mortality and prolonged working life may provide
survival benets among US adults.
Retirement is one of most important transitional
processes in later life. It has huge impacts on indivi-
dualsnancial resources, daily activities, family
relations and social network.
Over the past several
decades and until recently, workers have retired at
younger ages in the USA as well as in many other
developed countries.
This trend towards early
retirement along with several other ongoing demo-
graphic trends, including declining fertility rates,
prolonged life expectancy and delayed workforce
entry by young adults, has contributed to a shrink-
ing working population that may not be able to s-
cally support a rapidly growing retired
To alleviate scal pressure on the US
Social Security, the age eligibility for claiming full
retirement benets has been gradually increased
from 65 to 67 years, and benets available at age
62 years have been reduced.
Most recently,
research has pointed to a trend towards increased
retirement age.
Therefore, it is timely and critical
to develop a better understanding of whether and
how retirement age impacts retireeshealth and
longevity. Understanding the association of retire-
ment age with longevity has important implications
for postretirement survival and may elucidate cri-
teria for evaluating the current policies that aim to
encourage older workers to retire later and to
remain in the workforce.
There is a developing body of literature on the
relation between retirement age and longevity,
although the ndings are mixed. Several studies
reported higher mortality among early retirees than
those who retired around the institutionally norma-
tive age,
whereas others found no differences in
longevity between early and on-time retirees
or even a lower mortality among individuals retir-
ing early.
In sum, no consensus has been reached
on the existence, direction and magnitude of the
association between retirement age and longevity.
One major methodological challenge in studying
retirement age and mortality is how to account for
the healthy worker bias.
Poor health is an import-
ant reason for early retirement
21 22
and is also a
well-established risk factor for mortality.
23 24
Therefore, the adverse effects of early retirement
on longevity may be, at least partially, attributable
to workerspre-retirement health status.
Knowledge of the association of retirement age
with longevity is also limited by the use of non-
representative samples such as German regh-
US petrochemical workers
and Austrian
blue-collar workers.
This study aimed to investigate the association of
retirement age with mortality among US adults to
determine whether there is an optimal retirement
timing to preserve longevity. This study also
explored whether sociodemographic factors modi-
ed this relation. We addressed these issues using
data from the Health and Retirement Study (HRS),
a large, nationally representative prospective study
of US adults aged 51 years. To rigorously address
the healthy worker bias, we restricted the primary
analysis to participants who reported health had no
impact on their decision to retire.
We used data from the HRS collected between
1992 and 2010. The HRS is a co-operative agree-
ment between the National Institute on Aging and
the University of Michigan (U01 AG009740) and
aims to describe changes in life patterns through
Wu C, et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097 1
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JECH Online First, published on March 21, 2016 as 10.1136/jech-2015-207097
Copyright Article author (or their employer) 2016. Produced by BMJ Publishing Group Ltd under licence.
the retirement transition among US adults by collecting infor-
mation about their health conditions, family network, social
relations, nancial situation and employment status.
approval was obtained from the University of Michigan
Institutional Review Board. Further details about the recruit-
ment strategies, design and sampling approaches of the HRS
have been documented elsewhere.
There are currently six
cohorts enrolled in the HRS. This study focused on the initial
HRS cohort because it has the most waves of data for tracking
the occurrence of retirement and death events, and other study
cohorts comprised individuals who are either too young or too
old, providing limited information on retirement.
The sample was rst limited to 8756 participants who were
primary interview respondents (ie, not from a proxy respond-
ent) and had 2 valid assessments. The sample was further
restricted to 4092 participants who self-reported being working
at baseline and had retired by the end of the 2010 wave of data
collection. Moreover, because occupation and preretirement
health status were important confounders, 524 individuals
whose occupation information was unavailable and 454 indivi-
duals who did not report whether health was an important
reason to retire were excluded. Last, 158 individuals who were
lost to follow-up in the year when they reported being com-
pletely retired were also excluded. These selection criteria
resulted in a sample of 2956 eligible participants. The ow of
participants through each stage of selection based on inclusion
criteria is shown in gure 1.
To account for the healthy worker bias, the sample was strati-
ed into two subgroups, healthy and unhealthy retirees, based
on the question, Was poor health very important, moderately
important, somewhat important, or not important at all for
retirement?. Individuals who answered not important at all
were classied as healthy retirees, whereas individuals who
chose one of the other three answers were considered unhealthy
Figure 1 Flow chart of participants
excluded from the present study,
Health and Retirement Study, 1992
2WuC,et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097
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retirees. Consequently, the analytic sample consisted of 1934
healthy retirees (from 1782 households) and 1022 unhealthy
retirees (from 922 households).
Outcomes: The outcome was all-cause mortality. Participants
were censored when lost to follow-up or the end of the analytic
period (2010 survey wave). Mortality was ascertained on the
basis of a variable recording participantsyear and month of
death taken from an exit interview or a spouse/partners core
interview. Information on mortality was available through 2011.
Predictors: Retirement status was ascertained according to a
question asking respondents in each wave: At this time do you
consider yourself partly retired, completely retired or not
retired at all?An individual was dened as retired if they
responded, completely retired. Retirement age was dened as
the age when an individual, for the rst time, reported being
completely retired.
Covariates: To account for potential confounders, sociodemo-
graphic (birth cohort, gender, race dichotomised as white/non-
white, marital status dichotomised into married/non-married,
education categorised as <high school, high school and >high
school, non-housing wealth and preretirement occupation cate-
gorised into blue-collar, white-collar and service), lifestyle infor-
mation (smoking status, alcohol use and physical activity) and
health-related variables (body mass index, self-rated health, dis-
ability measured by difculties performing activities in daily
livings including walking across a room, bathing, eating, dress-
ing and getting into and out of bed, and medical history includ-
ing hypertension, diabetes, cancer, lung disease, heart problem,
stroke, arthritis and psychiatric problems) were included in the
multivariable analyses. All covariates were measured at baseline.
Statistical analysis
We rst compared the mean values of baseline characteristics
between healthy and unhealthy retirees, using a t test for con-
tinuous variables and a χ
test for categorical variables. We then
evaluated the distribution of retirement age for healthy and
unhealthy retirees separately.
We investigated the unadjusted association of retirement age
with mortality among healthy retirees in a Cox model.
Retirement age and its squared term were the primary predic-
tors. The purpose of including this quadratic term was to test
for a potential curvilinear relationship between retirement age
and mortality. The quadratic term was included in subsequent
models if it was associated with mortality at a signicance level
of p<0.05. Subsequently, we included all of the aforementioned
sociodemographic, lifestyles and health-related variables as con-
founders in the model to estimate the adjusted HRs for the mor-
tality risk per 1-year increase in retirement age. Additionally, we
examined the association of retirement age with mortality, mod-
elling the continuously measured retirement age in categories to
allow non-linear association. We rst classied healthy retirees
as early, on-time and late retirees using the rst and the third
quartiles of retirement age as cut-offs. Alternatively, we used
mean±1SD as cut-offs to classify healthy retirees into three
We evaluated effect modication by including interaction
terms between retirement age (continuous) and sociodemo-
graphic (birth cohort, gender, race, education, wealth, occupa-
tion and marital status) factors in the model and testing for
statistical signicance. Interaction terms that did not reach statis-
tical signicance (p0.05) were excluded from the nal model.
We used Schoenfeld residuals to assess the proportional hazards
assumption of Cox models.
As secondary analyses, Cox models were repeated for
unhealthy retirees. Additionally, pooled models including
healthy and unhealthy retirees were tted to test whether the
association of retirement age with mortality differed across two
subgroups. Furthermore, to assess the sensitivity of study results
to classication of healthy retirees, we repeated the analyses
using two more broad denitions of healthy retirees. Initially,
we categorised participants who reported health was somewhat
importantto retiring as healthy retirees (n=2143).
Alternatively, we categorised participants as healthy retirees
(n=2342) if they reported health was not at all,somewhator
moderately importantfor retirement. We used
inverse-probability-of-attrition weights (IPAW) to account for
potential selective attrition that may have arisen during
We centred retirement age at 65 years to reduce collinearity
between linear and quadratic terms and to improve
Table 1 Demographic, behavioural and health characteristics of
participants (healthy retirees vs unhealthy retirees), Health and
Retirement Study, 19922010
Healthy retirees
Unhealthy retirees
Mean±SD or count (%) p Value
Male 967 (50.0) 457 (44.7) **
White (vs non-White) 1628 (84.2) 775 (75.8) ***
Age 55.5±3.0 55.1±3.1 ***
Education ***
<High school 307 (15.9) 285 (27.9)
High school 1092 (56.4) 562 (55.0)
>High school 535 (27.7) 175 (17.1)
Married (vs others) 1487 (76.9) 666 (65.2) ***
Non-housing wealth ***
Min1st quartile 405 (20.9) 351 (34.3)
1st quartilemedian 472 (24.4) 262 (25.6)
498 (25.8) 251 (24.6)
3rd quartilemax 559 (28.9) 158 (15.5)
Occupation ***
White-collar 680 (35.2) 231 (22.6)
Service 756 (39.1) 446 (43.6)
Blue-collar 498 (25.8) 345 (33.8)
Smoking ***
Never-smoker 754 (39.0) 337 (33.0)
Former 756 (39.1) 373 (36.5)
Current 424 (21.9) 312 (30.5)
Alcohol use (yes) 1307 (67.6) 622 (60.9) ***
Frequent exercise 1041 (53.8) 498 (48.7) **
Body mass index ***
Underweight/normal 728 (37.6) 282 (27.6)
Overweight 843 (43.6) 422 (41.3)
Obese 363 (18.8) 318 (31.1)
Self-rated health 3.9±0.9 3.3±1.1 ***
Limitation in 1 ADL 42 (2.2) 81 (7.9) ***
Chronic conditions 0.9±0.9 1.5±1.2 ***
Death 234 (12.1) 262 (25.6) ***
*p<0.05. **p<0.01. ***p<0.001.
Two-sample t test for continuous variables and χ
test for categorical variables.
ADL, activities of daily living.
Wu C, et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097 3
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interpretation of the statistical results. We used robust SEs to
account for nested data structure of the HRS (ie, participants
nested within households). All statistical tests were two sided.
All analyses were conducted using Stata V.13.1.
A total of 2632 excluded participants were generally compar-
able to the included participants, except they were more often
males and more likely to be white-collar workers (see online
supplementary table S1).
Among 2956 participants included, 1934 (65.4%) and 1022
(34.6%) were classied as healthy and unhealthy retirees,
respectively. Over an average follow-up period of 16.9 years,
234 (12.1%) healthy and 262 (25.6%) unhealthy retirees died.
Compared with unhealthy retirees, healthy retirees were more
often men and white, more highly educated and more likely
married (table 1). They were also more likely to be white-collar
workers and had more wealth than unhealthy retirees. In add-
ition, healthy retirees were more physically active, less likely to
smoke, less likely to have a limitation in one or more activities
of daily living, had a lower body mass index, fewer chronic con-
ditions and better self-reported health than unhealthy retirees.
Overall, healthy retirees had relatively advantaged socio-
economic, behavioural and health proles.
The distribution of retirement age was similar among healthy
and unhealthy retirees, with a majority of people retiring
around the age of 65 years (gure 2). The average retirement
age (SD) was 64.9 (3.8) and 64.3 (4.1) years and the range was
53.378.0 and 54.779.4 years for healthy and unhealthy retir-
ees, respectively.
Among healthy retirees, older retirement age was signicantly
associated with lower mortality in the unadjusted model (table 2).
The addition of a quadratic term for retirement age did not
add signicantly to the model or alter the HR associated with
the linear term for retirement age. The association of retirement
age with mortality for healthy retirees remained nearly identical,
after adjusting for sociodemographic, lifestyle and health-related
covariates; retiring 1 year later was associated with an 11%
(95% CI 8% to 15%) lower mortality risk. Based on the χ
tests, there was no strong evidence suggesting that the propor-
tional hazards assumption was violated for any of the covariates
in the adjusted model (p >0.01; p=0.38 for global test).
Results of interaction analysis showed that none of the sociode-
mographic factors signicantly modied the association of
retirement age and mortality.
When retirement age was modelled categorically, 466 and
483 healthy retirees were classied as early (<62.4 years) and
late (>67.0 years) retirees using the rst and the third quartiles
as cut-offs, respectively. Alternatively, 252 and 297 healthy retir-
ees were considered early (<61.1 years) and late (>68.7 years)
retirees using mean±1SD as cut-offs, respectively. The ndings
obtained using two categorisation approaches consistently
showed that early and late retirees had signicantly higher and
lower mortality risk, respectively, compared with on-time retir-
ees (gure 3).
In the pooled analysis, unhealthy retirees had an 84% (95%
CI 51% to 126%) higher mortality risk than healthy retirees
(table 2). However, the association of retirement age with mor-
tality did not differ between these subgroups (p=0.83). When
unhealthy retirees were analysed separately, retiring 1 year later
was associated with a 9% (95% CI 6% to 12%) lower mortality
risk. The estimates for the association of retirement with mortal-
ity in healthy retirees remained almost unchanged when categor-
ising healthy retirees differently (see online supplementary table
S2). Results were virtually unchanged when we applied IPAW to
deal with potential selective attrition due to non-response (data
not shown).
In a population-based longitudinal study of US adults, we found
early retirement was associated with increased mortality risk,
and prolonged working life may be related to survival benets
among healthy and unhealthy retirees, independent of a wide
range of sociodemographic, lifestyle and health-related con-
founds. By using a cohort of US adults who do not face manda-
tory retirement and have a exible retirement arrangement, we
Figure 2 Distribution of retirement
age for healthy and unhealthy retirees,
Health and Retirement Study,
4WuC,et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097
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were able to extend previous research by showing late retire-
ment was independently related to a reduced risk of mortality.
Our ndings were consistent with previous investigations of
Austrian, German, Greek, Swedish and US populations showing
an increased mortality risk associated with early retirement.
Bamia et al
found early exit from the workforce was a risk
factor for mortality in Greek retirees who were free of chronic
conditions prior to retirement. In a more recent investigation of
Swedish residents who were healthy and employed at age
60 years, Carlsson et al
showed early retirement was associated
with an increased likelihood of death over the follow-up period.
The mechanisms behind the association of retirement age
with mortality are generally not well understood. One possible
explanation is employment is a key component of individuals
identity that provides them with substantial nancial, psycho-
social and cognitive resources. Additionally, retirement could be
a stressful life event associated with cognitive decline, difculties
in daily activities, morbidities, anxiety and depression.
20 2731
Delayed transition into retirement and continued participation
in volunteer activities and paid work in old age after retirement
could delay the declines in physical, cognitive and mental func-
tioning and reduce the risk of morbidities,
which leads to
better survival. This may be particularly true for individuals in
work-oriented countries, where work is highly valued and
considered a necessary part of life.
Work characteristics (eg,
more physically demanding or stressful jobs) may prompt earlier
retirement that may have longer term effects on health and mor-
tality even if workers do not retire due to health reasons.
Moreover, from the life course perspective, the decision about
when to retire is shaped by many factors, including cultural and
institutional norms; delayed transition into retirement may
become more socially and culturally desirable.
There was no evidence that the effects of retirement age on
mortality were modied by sociodemographic characteristics,
suggesting that the benecial effect of retiring late may be uni-
versal across different sociodemographic proles. Our ndings
are consistent with previous studies reporting an increased risk
of mortality associated with retiring early in homogeneous
11 13 14
Wagner et al
found early retirement was a
mortality risk among German reghters. Kuhn et al
a higher probability of dying before age 67 years among male
blue-collar workers who had access to early retirement than
those who were ineligible.
Pooled analyses including healthy and unhealthy retirees
showed unhealthy retirees had relatively high mortality. These
ndings were in line with previous studies showing individuals
who retired due to health-related reasons had relatively high
mortality risk.
Table 2 Association of retirement age with mortality, stratified by healthy versus unhealthy retirees, Health and Retirement Study, 19922010
Healthy retirees (n=1934) Unhealthy retirees (n=1022) Pooled analysis* (n=2956)
HR 95% CI
Retirement age (centred at 65) 0.89 0.86 to 0.92 0.90 0.87 to 0.92 0.89 0.87 to 0.91
Retirement age (centred at 65) 0.89 0.85 to 0.92 0.91 0.88 to 0.94 0.90 0.88 to 0.92
Retired due to health (yes) –– –– 1.84 1.51 to 2.26
Male 1.66 1.21 to 2.27 1.79 1.33 to 2.43 1.75 1.41 to 2.17
White (vs non-white) 1.11 0.75 to 1.66 1.03 0.76 to 1.40 1.04 0.82 to 1.33
Birth cohort (centred at 1931) 1.02 0.96 to 1.09 1.01 0.96 to 1.07 1.02 0.98 to 1.06
Education (ref. <high school)
High school 0.67 0.47 to 0.96 0.85 0.63 to 1.15 0.79 0.62 to 0.99
>High school 0.66 0.40 to 1.07 1.21 0.73 to 2.00 0.90 0.63 to 1.28
Married (vs others) 0.81 0.59 to 1.13 0.98 0.73 to 1.33 0.90 0.72 to 1.13
Wealth (ref. <1st quartile)
1st quartilemedian 1.21 0.83 to 1.76 0.96 0.69 to 1.35 1.09 0.85 to 1.39
Median3rd quartile 0.97 0.64 to 1.47 0.90 0.63 to 1.30 0.93 0.71 to 1.22
3rd quartilemax 0.97 0.63 to 1.49 0.90 0.57 to 1.42 0.91 0.67 to 1.23
Occupation (ref. white-collar)
Service 0.93 0.64 to 1.35 1.30 0.84 to 2.01 1.11 0.84 to 1.48
Blue-collar 0.97 0.64 to 1.46 1.19 0.77 to 1.83 1.09 0.81 to 1.46
Smoking (ref. never-smokers)
Former smokers 1.25 0.88 to 1.77 1.37 0.96 to 1.93 1.33 1.04 to 1.71
Current smokers 2.66 1.88 to 3.77 2.55 1.82 to 3.57 2.59 2.03 to 3.31
Drinking (yes) 0.94 0.70 to 1.27 0.85 0.65 to 1.12 0.90 0.73 to 1.10
Frequent exercise (yes) 1.04 0.80 to 1.34 0.74 0.57 to 0.95 0.87 0.72 to 1.04
BMI (ref. normal/low)
Overweight 0.89 0.66 to 1.19 1.07 0.78 to 1.47 0.97 0.78 to 1.20
Obese 1.24 0.86 to 1.77 1.09 0.76 to 1.55 1.13 0.88 to 1.46
Self-rated health 0.90 0.77 to 1.05 0.91 0.80 to 1.05 0.91 0.82 to 1.01
Chronic conditions 1.22 1.05 to 1.40 1.12 1.00 to 1.26 1.16 1.06 to 1.27
Limitation in any ADL 2.32 1.18 to 4.56 0.97 0.64 to 1.48 1.14 0.79 to 1.66
*Both healthy and unhealthy retirees were included. p Value for interaction, retirement age×retired due to health (yes or no)=0.834.
Estimates adjusted for sociodemographic (birth cohort, gender, marital status, education, wealth), lifestyle (smoking status, alcohol use, body mass index) and health-related (self-rated
health, medical history and activities of daily living) measures.
ADL, activities of daily living; BMI, body mass index.
Wu C, et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097 5
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This study had several distinct substantive and methodological
strengths. First, we used a large sample from a nationally repre-
sentative study with rich sociodemographic, lifestyle and health
information. Second, we rigorously accounted for the confound-
ing effects of preretirement health status by restricting the
primary analysis to retirees who self-reported health was not
important for retirement. Using self-reported information to
dene healthy retirees appeared valid, as evidenced by the fact
that healthy retirees had relatively advantaged socioeconomic,
behavioural and health proles. Additionally, self-reported
health is arguably better than objectively measured health since
subjective evaluations of health may have the largest impact on
an individuals choice to retire.
39 40
Third, unlike most previous
studies, we examined the health effect of both early and late
retirement. Fourth, in addition to examining the main effect of
retirement age on mortality, we investigated whether this rela-
tion differed across sociodemographic subgroups. Finally, this
study had a long follow-up period, which allows the investiga-
tion of long-term survival and provides sufcient death events
to achieve statistical power.
We acknowledge several limitations in this study. First, this
study focused exclusively on retirement age and mortality.
Future research should investigate the mechanisms by which
retirement age impacts longevity to have a better understanding
of the relationship between retirement age and trajectories of
health and quality of life before and after retirement. Second,
the question used in this study to dene healthy retirees does
not necessarily identify whether their health was the dominant
reason for them to retire. The decision about when to retire is
multifactorial and complex;
it is possible that individuals who
considered health was important for retirement indeed left the
workforce owing to a variety of reasons related to, but not dir-
ectly indicative of, poor health, although we argue this den-
ition was the most conservative approach to control for
confounding by poor health status. Third, as with any observa-
tional study, residual confounding may persist if important con-
founders were omitted.
In general, this study adds to the retirement literature by study-
ing a representative US cohort and using a rigorous denition of
healthy retirees. The study ndings may have important implica-
tions for policies concerning the labour market, retirement and
later life health. In the context of rising longevity, changes in
retirement ages across cohorts and young adults delaying entry
into the workforce, policymakers have pressed for policy changes
encouraging late retirement to alleviate the old-age dependency
ratio. In addition to the economic and social impacts of delaying
retirement age, it is also important to consider the health conse-
quences of retirement for policy evaluation. This study suggests
late retirement has a benecial effect on longevity and early
retirement is associated with higher mortality. In this sense, redu-
cing early retirement benets, providing social and economic
incentives to prolong working life and enacting policies that aim
to postpone retirement may be benecial for individualshealth.
What is already known on this subject
Previous studies reported conicting results regarding the
health effects of retirement age.
Prior research has not sufciently accounted for the healthy
worker bias.
The health effects of late retirement have been rarely
What this study adds
Early retirement may be a risk factor for mortality and
prolonged working life may provide survival benets.
The relation between retirement age and mortality did not
vary across sociodemographic subgroups.
Figure 3 Association of categorised retirement age with mortality in healthy retirees, Health and Retirement Study, 19922010. Note: On-time
retirees were considered reference group.
6WuC,et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097
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Acknowledgements The authors wish to thank Dr Richard A Settersten and Dr
Adam J Branscum for their review of earlier versions of this manuscript.
Contributors CW conceived of and designed the study, conducted the analyses,
interpreted the ndings and wrote and revised the manuscript. RSS contributed to
the study design, subject matter expertise, interpretation of the data and drafting of
the manuscript. MCO contributed statistical expertise, interpretation of the data and
drafting of the manuscript. GGF contributed to subject matter expertise and drafting
of the manuscript. All authors were involved in article revisions and have approved
the nal version.
Funding This work was supported by a grant from National Institute on Aging
(NIA): R03-AG042919-01, and a Pilot Grant from the Michigan Center on the
Demography of Aging: P30-AG012846.
Competing interests None declared.
Ethics approval University of Michigan Institutional Review Board.
Provenance and peer review Not commissioned; externally peer reviewed.
1 Doyle Y, McKee M, Rechel B, et al. Meeting the challenge of population ageing.
BMJ 2009;339:b3926.
2 Gendell M. Retirement age declines again in 1990s. Monthly Lab Rev
3 Wheaton F, Crimmins EM. The demography of aging and retirement. In: Wang M, ed.
Handbook of retirement. Oxford University Press, 2013.
4 Leibfritz W. Retiring later makes sense. Korea 2002;60:68.
5 Vaupel JW, Loichinger E. Redistributing work in aging Europe. Science
6 McGee JP, Wegman DH. Health and safety needs of older workers. National
Academies Press, 2004.
7 Fisher GG, Chaffee DS, Sonnega A. Retirement Timing: A Review and
Recommendations for Future Research. Work, Aging and Retirement 2016; doi:10.
8 Munnell AH. The Average Retirement Age: An Update. Issue in Brief 154.
Chestnut Hill, MA: Center for Retirement Research at Boston College; 2015.
9 Bamia C, Trichopoulou A, Trichopoulos D. Age at retirement and mortality in a
general population sample: the greek EPIC study. Am J Epidemiol 2008;167:5619.
10 Carlsson S, Andersson T, Michaëlsson K, et al. Late retirement is not associated
with increased mortality, results based on all Swedish retirements 19912007. Eur J
Epidemiol 2012;27:4836.
11 Kuhn A, Wuellrich JP, Zweimüller J. Fatal attraction? Access to early retirement and
mortality. IZA Discussion Papers 5160, The Institute for the Study of Labor (IZA)
12 Kühntopf S, Tivig T. Early retirement and mortality in Germany. Eur J Epidemiol
13 Wagner NL, Berger J, Flesch-Janys D, et al. Mortality and life expectancy of
professional re ghters in Hamburg, Germany: a cohort study 19502000. Environ
Health 2006;5:27.
14 Waldron H. Links between early retirement and mortality. Social Security
Administration, Ofce of Policy, Ofce of Research, Evaluation, and Statistics, 2001.
15 Hernaes E, Markussen S, Piggott J, et al. Does retirement age impact mortality?
J Health Econ 2013;32:58698.
16 Hult C, Stattin M, Janlert U, et al. Timing of retirement and mortalitya cohort
study of Swedish construction workers. Soc Sci Med 2010;70:14806.
17 Litwin H. Does early retirement lead to longer life? Ageing Soc 2007;27:73954.
18 Tsai SP, Wendt JK, Donnelly RP, et al. Age at retirement and long term survival of
an industrial population: prospective cohort study. BMJ 2005;331:995.
19 Brockmann H, Müller R, Helmert U. Time to retiretime to die? A prospective
cohort study of the effects of early retirement on long-term survival. Soc Sci Med
20 Dave D, Rashad I, Spasojevic J. The effects of retirement on physical and mental
health outcomes. South Econ J 2008;75:497523.
21 Mein G, Martikainen P, Stansfeld SA, et al. Predictors of early retirement in British
civil servants. Age Ageing 2000;29:52936.
22 Rice NE, Lang IA, Henley W, et al. Common health predictors of early retirement:
ndings from the English Longitudinal Study of Ageing. Age Ageing
23 Harris SE, Deary IJ, MacIntyre A, et al. The association between telomere length,
physical health, cognitive ageing, and mortality in non-demented older people.
Neurosci Lett 2006;406:2604.
24 Lee Y. The predictive value of self assessed general, physical, and mental health on
functional decline and mortality in older adults. J Epidemiol Community Health
25 Juster FT, Suzman R. An overview of the Health and Retirement Study. J Human
Resources 1995:S7S56.
26 Heeringa SG, Connor JH. Technical description of the health and retirement survey
sample design. Ann Arbor: University of Michigan, 1995.
27 Bossé R, Aldwin CM, Levenson MR, et al. Mental health differences among retirees
and workers: ndings from the Normative Aging Study. Psychol Aging 1987;2:383.
28 Elwell F, Maltbie-Crannell AD. The impact of role loss upon coping resources and
life satisfaction of the elderly. J Gerontol 1981;36:22332.
29 Kim JE, Moen P. Retirement transitions, gender, and psychological well-being a
life-course, ecological model. J Gerontol B Psychol Sci Soc Sci 2002;57:P21222.
30 Olesen K, Rugulies R, Rod NH, et al. Does retirement reduce the risk of myocardial
infarction? A prospective registry linkage study of 617 511 Danish workers. Int J
Epidemiol 2014;43:1607.
31 Roberts BA, Fuhrer R, Marmot M, et al. Does retirement inuence cognitive
performance? The Whitehall II Study. J Epidemiol Community Health
32 Dufouil C, Pereira E, Chêne G, et al. Older age at retirement is associated with
decreased risk of dementia. Eur J Epidemiol 2014;29:35361.
33 Fisher GG, Stachowski A, Infurna FJ, et al. Mental work demands, retirement, and
longitudinal trajectories of cognitive functioning. J Occup Health Psychol
34 Luoh MC, Herzog AR. Individual consequences of volunteer and paid work in old
age: health and mortality. J Health Soc Behav 2002;43:490509.
35 Rennemark M, Berglund J. Decreased cognitive functions at the age of 66, as
measured by the MMSE, associated with having left working life before the age of
60: results from the SNAC study. Scand J Public Health 2014;42:3049.
36 Stenholm S, Westerlund H, Salo P, et al. Age-related trajectories of physical
functioning in work and retirement: the role of sociodemographic factors, lifestyle
and disease. J Epidemiol Community Health 2014;68:5039.
37 Oakman J, Wells Y. Retirement intentions: what is the role of push factors in
predicting retirement intentions? Ageing Soc 2013;33:9881008.
38 Fisher GG, Ryan LH, Sonnega A. Prolonged working years: consequences and
directions for interventions. In: Vuori J, Blonk R, Price RH (eds) Sustainable working
lives. Springer, 2015:26988.
39 Bound J. Self-reported vs. objective measures of health in retirement models.
National Bureau of Economic Research, 1989.
40 Adams GA, Beehr TA. Retirement: reasons, processes, and results. Springer
Publishing Company, 2003.
Wu C, et al.J Epidemiol Community Health 2016;0:17. doi:10.1136/jech-2015-207097 7
Research report
... Retirement is a major later-life turning point. Literature is ambiguous on whether those past this transition face increased mortality risk than their working peers, or release from strain and positive health effects (Bellés Obrero et al., 2022;Fitzpatrick & Moore, 2018;Sewdas et al., 2020;Wu et al., 2016). Age acceleration is an increasingly accepted way to capture early-stage mortality risk (Chen et al., 2016;Dugué et al., 2018;Fransquet et al., 2019;Hillary et al., 2020;Lu et al., 2019). ...
... First, retirement may release a person from adverse physical and/or psychosocial work pressures, and hence lower mortality risk (Kolodziej & García-Gómez, 2019;Odone et al., 2021). On the other hand, this transition comes with a loss of workplace identities and psychosocial assets, leading potentially to unhealthy lifestyles and increased mortality risk (Wang et al., 2011;Wu et al., 2016). Credible meta-analytic and population representative investigations yield retirement effects in both directions. ...
... On-time retirement, in contrast, was associated with a higher risk-possibly due to selection into this status among those with worse health (i.e., the "healthy worker" effect). Somewhat contradictory to these findings, Wu et al. (2016) used HRS data to show that early retirement may indeed be a mortality risk factor. In another HRS based study, Fitzpatrick and Moore (2018) found a 2% increase in male mortality immediately after age 62-the threshold for U.S. Social Security eligibility. ...
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Purpose This study examined associations of older men’s and women’s retired status with their biological age acceleration, and mediation of these linkages by depressive symptoms. Methods Data were from the 2010–2016 waves of the Health and Retirement Study, nationally representative of older U.S. adults. Age acceleration was proxied through newly available epigenetic measures. Doubly robust estimation was used to establish baseline linkages, and heterogenous treatment effect models to examine variations in effects by one’s increasing propensity to be retired. Mediation analysis was through a recently developed regression-with-residuals (RWR) approach for structural nested mean models. Results Six years after treatment assessment, women retired at baseline showed faster aging than those fully employed. Retired men’s subsequent depressive symptoms were lower, with sparse results also supporting their slower senescence. Associations did not significantly change with increasing propensity for being retired, for either gender. Conclusion Results provide novel evidence for retirement’s gender-specific senescence effects. Potential lifestyle mechanisms remain unexplored. Individual and policy implications are discussed.
... 89 For example, in the United States, a study of nearly 3,000 workers found that a one-year increase in the age of retirement was associated with an 11 percent decline in all-cause mortality among "healthy" workers, as well as a 9 percent decline among "unhealthy" retirees. 90 One study spanning eleven European countries found that working for pay was associated with higher cognitive performance among people ages sixty to sixty-four, whereas retirement lowered scores on a 20-point memory test by 4.9 points, on average. 91 To be sure, the effects vary depending on the nature of the job; remaining in a job that entails poor working conditions, requires long hours, or imposes infeasible physical demands is unlikely to benefit health. ...
Well into the twenty-first century, achieving gender equality in the economy remains unfinished business. Worldwide, women’s employment, income, and leadership opportunities lag men’s. Building and using a one-of-a-kind database that covers 193 countries, this book systematically analyzes how far we’ve come and how far we have to go in adopting evidence-based solutions to close the gaps. Spanning topics including girls’ education, employment discrimination of all kinds, sexual harassment, and caregiving needs across the life course, the authors bring the findings to life through global maps, stories of laws’ impact in courts and beyond, and case studies of making change. A powerful call to action, Equality within Our Lifetimes reveals how gender equality is both feasible and urgently needed to address some of the greatest challenges of our generation.
... This came in agreement with European survey especially participants from Denmark (58%); the Netherlands (55%), Ireland (53%), the UK (51%) and Austria (49%) are most likely to feel that it needs to increase. This opinion is supported by the study conducted in USA, 2016 that assures on the importance of delaying retirement and concluded that early retirement may be a risk factor for mortality and prolonged working life may provide survival benefits among US adults (Wu et al, 2016). ...
... Other analyses have suggested that cognitive declines nearly double post-retirement (Sap and Denier 2017). Underscoring the impact extended work has on longevity, mortality rates decreased among those who worked past age 65 (Wu et al. 2016). These post-retirement deteriorations stemmed not from the absence of work, but from smaller social networks and increased isolation. ...
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Notwithstanding the terrible price the world has paid in the Coronavirus pandemic, the fact remains that longevity at older ages is likely to continue to rise in the medium and longer term. This volume explores how the private and public sectors can collaborate via public-private partnerships (PPPs) to develop new mechanisms to reduce older people’s risk of outliving their assets in later life. As we show in this volume, PPPs typically involve shared government financing alongside private-sector partner expertise, management responsibility, and accountability. In addition to offering empirical evidence on examples where this is working well, our contributors provide case studies, discuss survey results, and examine a variety of different financial and insurance products to better meet the needs of the aging population. The volume will be informative to researchers, plan sponsors, students, and policymakers seeking to enhance retirement plan offerings.
... Moreover, as researchers at Oregon State University (Wu, Odden, Fisher, & Stawski, 2016) have shown from a wide-ranging review of national data, ending employment and retiring early can actually shorten a person's life, while working longer can lengthen it (contra, Sewdas et al., 2020, though not specifically addressing the earlier Oregon findings). Indeed, according to the Oregon study, the bonus of increased longevity applied to those who were healthy when they retired as well as to those who were notwith mortality reduced by an average of 10% among those who worked a year longer past their normal retirement date. ...
Objective To explore the theme of retirement in the epic tale of Odysseus and the implications it can have for contemporary retirees in the light of recent empirical research. Methods Homer's Odyssey (ca. 8th cent. B.C.E.) and Tennyson's poem “Ulysses” (1833) were closely read and compared to disclose the impact retirement had on a literary character who had for most of his life thrived on action. Results While Homer avoided directly describing the quality of Odysseus' life once he had returned home from war, Tennyson focused on it, arguing that a life devoid of adventure would have been intolerable for such a personality. Discussion Seeking out new adventures and experiences, despite one's age, may serve to mitigate one of the most common negative components of retirement today, boredom, and thereby lengthen and enhance the quality of retirees' lives.
As older individuals play instrumental roles in supporting their families and contributing to their workplaces, it is essential to understand how society perceives them in relation to these social roles. This study compares age-based (e.g. senior citizen), familial role-based (e.g. grandmother) and occupational role-based framing (e.g. old(er) doctor) of older adults over 210 years in the United States, and explores the sentiments and narratives associated with each type of framing. We created the largest historical corpus of American English - a 600-million-word-dataset comprising over 150,000 texts and spanning 210 years (1810-2019). Top descriptors (N = 135,659) of nouns related to age (e.g. senior citizen), familial roles (e.g. grandmother) and occupational roles (e.g. old(er) doctor) were compiled and rated for valence (negative-positive) on a 5-point scale. Age-based framing was associated with the most negative portrayals of older adults, specifically a 16% decline over 210 years. Foregrounding their familial roles buffered this negativity and resulted in a 4% decline. Occupational roles were associated with the most positive portrayals of older adults, increasing by 2% over the same period. Our findings underscore the need for society to unlearn any false and harmful beliefs surrounding older adults' abilities and contributions. We propose a strategy to reframe aging by de-emphasizing age and adopting a role-centric approach.
Background: Research on mortality at the population level has been severely restricted by an absence of linked death registration and survey data in Ireland. We describe the steps taken to link death registration information with survey data from a nationally representative prospective study of community-dwelling older adults. We also provide a profile of decedents among this cohort and compare mortality rates to population-level mortality data. Finally, we compare the utility of analysing underlying versus contributory causes of death. Methods: Death records were obtained for 779 and linked to individual level survey data from The Irish Longitudinal Study on Ageing (TILDA). Results: Overall, 9.1% of participants died during the nine-year follow-up period and the average age at death was 75.3 years. Neoplasms were identified as the underlying cause of death for 37.0%; 32.9% of deaths were attributable to diseases of the circulatory system; 14.4% due to diseases of the respiratory system; while the remaining 15.8% of deaths occurred due to all other causes. Mortality rates among younger TILDA participants closely aligned with those observed in the population but TILDA mortality rates were slightly lower in the older age groups. Contributory cause of death provides similar estimates as underlying cause when we examined the association between smoking and all-cause and cause-specific mortality. Conclusions: This new data infrastructure provides many opportunities to contribute to our understanding of the social, behavioural, economic, and health antecedents to mortality and to inform public policies aimed at addressing inequalities in mortality and end-of-life care.
Background: Approximately half of the people who are blind or have low vision in the U.S. are not in the labor force, yet we know little about their characteristics or reasons for being out of the labor force. Objective/hypothesis: The objective of this study was to compare people with blindness or low vision who reported being unable to work to those out of the labor force for other reasons, unemployed, and employed, and investigate characteristics that differentiate these groups. Methods: Our sample of people with blindness or low vision was selected from the Behavioral Risk Factor Surveillance System to compare people who reported being unable to work to those in other employment groups utilizing multinomial logistic regression. Results: The majority of people out of the labor force reported they were unable to work. People unable to work were likely to have low income, more chronic health conditions, days with poor physical health, and functional disabilities than all other groups. They were also more likely to have access to health care than other groups and were more likely to be male and uncoupled compared to those out of the labor force for other reasons. Conclusions: People who reported being unable to work had more chronic health and functional disability issues. Because being out of the labor force puts one at economic risk, further research is indicated to assess policy issues and strategies that might identify employment options that accommodate people with blindness or low vision and additional health issues and disabilities.
This paper presents a meta‐analysis on the effects of retirement on health. We selected academic papers published between 2000 and 2021 and studying the impact of retirement on physical and mental health, self‐assessed general health, healthcare utilization and mortality. Our search resulted in a dataset consisting of 308 observations from 85 articles. Using meta‐regression analysis and after checking for the presence of publication bias, we found that the average effect of retirement on health outcomes is very small and barely significant, under the assumption of a common true effect. We applied model averaging techniques to explore possible sources of heterogeneity of the true effect. Our findings suggest that effect heterogeneity across results is explained by the differences in both health measurements and retirement schemes. In particular, mandatory or involuntary retirement is associated with a negative impact of retirement on health, although it is small in magnitude.
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Age-related changes in cognitive abilities are well-documented, and a very important indicator of health, functioning, and decline in later life. However, less is known about the course of cognitive functioning before and after retirement and specifically whether job characteristics during one's time of employment (i.e., higher vs. lower levels of mental work demands) moderate how cognition changes both before and after the transition to retirement. We used data from n = 4,182 (50% women) individuals in the Health and Retirement Study, a nationally representative panel study in the United States, across an 18 year time span (1992-2010). Data were linked to the O*NET occupation codes to gather information about mental job demands to examine whether job characteristics during one's time of employment moderates level and rate of change in cognitive functioning (episodic memory and mental status) both before and after retirement. Results indicated that working in an occupation characterized by higher levels of mental demands was associated with higher levels of cognitive functioning before retirement, and a slower rate of cognitive decline after retirement. We controlled for a number of important covariates, including socioeconomic (education and income), demographic, and health variables. Our discussion focuses on pathways through which job characteristics may be associated with the course of cognitive functioning in relation to the important transition of retirement. Implications for job design as well as retirement are offered. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Mirroring a worldwide phenomenon in industrialized nations, the U.S. is experiencing a change in its demographic structure known as population aging. Concern about the aging population tends to focus on the adequacy of Medicare and Social Security, retirement of older Americans, and the need to identify policies, programs, and strategies that address the health and safety needs of older workers. Older workers differ from their younger counterparts in a variety of physical, psychological, and social factors. Evaluating the extent, causes, and effects of these factors and improving the research and data systems necessary to address the health and safety needs of older workers may significantly impact both their ability to remain in the workforce and their well being in retirement. Health and Safety Needs of Older Workers provides an image of what is currently known about the health and safety needs of older workers and the research needed to encourage social polices that guarantee older workers a meaningful share of the nation's work opportunities. © 2004 by the National Academy of Sciences. All rights reserved.
There are many economic, social, and psychological reasons why individuals are working longer or until later ages than in decades past. This chapter considers the potential impact—both good and bad—of working longer and proposes interventions aimed at maximizing positive outcomes and mitigating negative ones. We begin with a theoretical framework for understanding consequences of prolonged work. Second, we discuss some reasons for working longer. Third, we describe results from a nationally representative study of older adults in the U.S. Fourth, we review some of the consequences of prolonged work based on empirical research findings. Finally, we describe interventions that should be considered to promote longer work lives and to ameliorate potentially negative consequences of working longer. We conclude with a summary and recommendations for future research.
Although there have been many reviews of the retirement literature in recent years, the issue of retirement timing has received less attention, neglecting some large and important issues. Further, a significant number of empirical articles about retirement timing have been published across multiple disciplines since these review articles were written. The purpose of our study is to review and integrate prior research regarding retirement timing. We define retirement timing as the age or relative point at which workers exit from their position or career path (e.g., early, on time, and later). We propose a model to serve as an organizing framework for understanding retirement timing. Our model includes antecedents and consequences that are each grouped in terms of individual, family, work, and sociocultural factors related to the timing of the retirement process. We identify and discuss key factors that serve to moderate the relation between retirement timing and consequences. Finally, we identify gaps in the current literature and provide recommendations for future research.
Researchers during the past decade have found little effect of retirement on physical health. However, retirement entails a number of losses, and its effect on mental health, as measured by the prevalence of psychological symptoms, is unclear. We examined psychological symptoms in a sample of 1,513 older men, participants in the Normative Aging Study, using the SCL-90-R (Derogatis, 1983). Analyses of variance indicated that retirees reported more psychological symptoms than did workers, even after controlling for physical health status. Exploratory analyses examining the circumstances of retirement found no effects for length of retirement or part-time employment, but did find effects for the timing of retirement. Both early and late retirees reported more psychological symptoms. Late workers (aged 66 and older) reported the fewest symptoms. Reasons for these findings are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
BACKGROUND: it is uncertain how recent changes in labour force dynamics may have influenced the increasing numbers of people taking early retirement in industrialized countries. The Whitehall II study provides an opportunity to examine the predictors of early retirement in one of the largest employers in the United Kingdom. METHODS: we examined the factors predicting early retirement in a 7-year follow-up period from 1988 to 1995 using longitudinal data on 2532 male and female London-based civil servants aged between 50 and 59.5 years. Baseline data on employment grade and duration of time working for the Civil Service were obtained from self-completed questionnaires. The primary factors examined included health, work characteristics, questions about job demands and job satisfaction and financial insecurity, wealth and material problems. Time until early retirement was analysed using Cox proportional hazards model. RESULTS: of the 2532 civil servants, 26.7% retired early during the follow-up period. We found that men and women in the higher-paid employment grades, those that had suffered from ill health and those that were less satisfied with their jobs were more likely to retire early, whereas material problems tended to keep people working. CONCLUSIONS: our results show that self-perceived health, employment grade and job satisfaction are all independent predictors of early retirement. Qualitative analyses may further advance our understanding of the retirement process.
After nearly a century of decline, work activity among older people began to increase in the 1980s in response to a variety of factors. The question is whether the impacts of those factors have played themselves out in recent years or whether the trend toward working longer has continued. Since working longer is the key to a secure retirement, the labor force activity of people in their 50s and 60s is a crucial issue. This brief proceeds in four steps. The first section describes the turnaround in labor force activity that began in the 1980s, within the context of the long-run decline in the labor force participation of men. The second section describes the factors responsible for that turnaround. The third section looks at the labor force participation rates of men and women for four years – 1963, 1983, 2003, and 2013 – showing recent workforce activity significantly above the low point in the 1980s. The fourth constructs, for men and women, average retirement ages – the age when 50 percent of the population is out of the labor force. Today’s average retirement ages of 64 for men and 62 for women are just about where they were a decade ago, suggesting that some of the factors spurring the turnaround since the 1980s may have exhausted themselves. The final section concludes that, given the importance of working longer for retirement security, a major educational initiative may be warranted to help convince individuals of the benefits.
To test the hypothesis that age at retirement is associated with dementia risk among self-employed workers in France, we linked health and pension databases of self-employed workers and we extracted data of those who were still alive and retired as of December 31st 2010. Dementia cases were detected in the database either through the declaration of a long-term chronic disease coded as Alzheimer's disease and other dementia (International Classification of Disease codes G30, F00, F01, F03) or through the claim for reimbursement of one of the anti-dementia drugs. Data were analyzed using Cox proportional hazard model adjusting for potential confounders. Among the 429,803 retired self-employed workers alive on December 31st 2010, prevalence of dementia was 2.65 %. Multivariable analyses showed that the hazard ratio of dementia was 0.968 [95 % confidence interval = (0.962-0.973)] per each extra year of age at retirement. After excluding workers who had dementia diagnosed within the 5 years following retirement, the results remained unchanged and highly significant (p < 0.0001). We show strong evidence of a significant decrease in the risk of developing dementia associated with older age at retirement, in line with the "use it or lose it" hypothesis. Further evidence is necessary to evaluate whether this association is causal, but our results indicate the potential importance of maintaining high levels of cognitive and social stimulation throughout work and retiree life.