Article

Work ability in midlife as a predictor of mortality and disability in later life: A 28-year prospective follow-up study

Gerontology Research Centre, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Canadian Medical Association Journal (Impact Factor: 5.96). 03/2011; 183(4):E235-42. DOI: 10.1503/cmaj.100713
Source: PubMed

ABSTRACT

Poor work ability correlates with increased morbidity and early retirement from the workforce, but the association in old age is not known. We investigated work ability in midlife among white-collar and blue-collar employees as a predictor of mortality and disability 28 years later.
A total of 5971 occupationally active people aged 44-58 years participated in the Finnish Longitudinal Study of Municipal Employees (FLAME) in 1981. Perceived work ability relative to lifetime best was categorized as excellent, moderate or poor. In 2009, the ability to perform activities of daily living was assessed among 2879 respondents (71.0% of the survivors). Mortality data were available up to July 2009.
At the 28-year follow-up, 1918 of the 5971 participants had died and 1403 had some form of disability. Rates of death per 1000 person-years among white-collar men were 7.7 for those with excellent work ability, 14.7 for those with moderate work ability and 23.5 for those with poor work ability. Among blue-collar men, the corresponding rates were 15.5, 20.2 and 25.3. In women, rates ranged between 6.3 and 10.6 per 1000 person-years. The age-adjusted hazard ratios (HRs) for mortality were two to three times higher among blue-collar male employees with lower work ability than among white-collar male employees with excellent work ability in midlife (i.e., the reference group). The odds of death or disability at follow-up compared with white-collar workers with excellent work ability were highest among blue-collar employees with poor work ability in midlife (odds ratio [OR] 4.56, 95% confidence interval [CI] 2.82-7.37 for men; OR 3.37, 95% CI 2.28-4.98 for women). Among the survivors, similar but slightly lower risks of disability 28 years later were found.
Perceived poor work ability in midlife was associated with accelerated deterioration in health and functioning and remains evident after 28 years of follow-up.

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    • "We examine negative affectivity, which we propose will positively relate to IER based on the rationale provided above related to its mean departing from scale midpoints. Further, we expect that perceived work ability will correlate negatively with perceived disability based findings fromMcGonagle et al. (2015)and vonBonsdorff et al. (2011). Due to the hypothesised presence of IER as a common confound, we propose that the correlations between perceived work ability and both negative affectivity and disability will be stronger (inflated) when IER respondents are included in the sample as opposed to when the IER respondents are removed. "
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    ABSTRACT: Insufficient effort responding (IER) is problematic in that it can add a systematic source of variance for variables with average responses that depart from the scale midpoints. We present a rationale for why IER is of particular importance to Work and Organisational Health Psychology (WOHP) researchers. We also demonstrate its biasing effects using several variables of interest to WOHP researchers (perceived work ability, negative affectivity, perceived disability, work–safety tension, accident/injury frequencies, and experienced and instigated incivility) in two datasets. As expected, IER was significantly correlated with the focal study variables. We also found some evidence that hypothesised bivariate correlations between these variables were inflated when IER respondents were included. Corroborating IER's potential confounding role, we further found significant declines in the magnitude of the hypothesised bivariate correlations after partialling out IER. In addition, we found evidence for biasing (under-estimation) effects for predictors not contaminated by IER in multiple regression models where some predictors and the outcome were both contaminated by IER. We call for WOHP researchers to routinely discourage IER from occurring in their surveys, screen for IER prior to analyzing survey data, and establish a standard practice for handling IER cases.
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    • "The work ability concept is an important consideration in the P–E framework as it is based on both an individual's perceptions of the demands of work and their self-rated ability to cope with these demands (Feldt et al. 2009). One measure of work ability – the Work Ability Index (WAI) – was developed in 1981 by Ilmarinen, Tuomi and Seitsamo (2005) and has been used extensively to identify and quantify employee workability and its relationships with health and retirement (Feldt et al. 2009; Sell et al. 2009; von Bonsdorff et al. 2011). Links have been established between workability and both psychosocial workplace factors and job satisfaction (Oakman and Wells 2013; van den Berg et al. 2008). "
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    • "Work, on the other hand covers the work environment and community, as well as the actual contents, demands, and organization of work (management and supervision included) [1]. The factors that help to promote or reduce work ability have been studied in several countries and, due to an aging population, an increasing number of studies have focused primarily on promoting and maintaining this work ability [1] [2] [3] [4]. The assumption underlying most of these studies is that adequate work ability is associated with good quality of life at work and increased chances for a delayed and healthier retirement [5]. "
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