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


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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