Gerontology Research Centre, Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
Aging Clin Exp Res. 2012 Aug;24(4):354-60. doi: 10.3275/8107. Epub 2011 Nov 16.
Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age.
Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, perceived work ability relative to lifetime best was categorized into excellent, moderate, and poor work ability. At follow-up, disability scales were constructed based on the severity and frequency of difficulties reported in self-care activities of daily living (ADL) and instrumental activities of daily living (IADL).
There was a graded prevalence of ADL and IADL disability severity, according to excellent, moderate and poor midlife work ability (p<0.001). Employees with moderate midlife work ability had an 11 to 20% higher mean ADL or IADL disability severity score, compared with those with excellent midlife work ability (reference), incidence rate ratios (IRR) ranging from 1.11 (95% CI 1.01-1.22) to 1.20 (95% CI 1.10-1.30). Those with poor midlife work ability had a mean ADL or IADL disability severity score 27 to 38% higher than the referent, IRRs ranging from 1.27 (95% CI 1.09-1.47) to 1.38 (95% CI 1.25-1.53). Adjusting for socio-economics, lifestyle factors and chronic diseases only slightly attenuated the associations.
Work ability, an indicator of the de- mands made by mental and physical work relative to individuals' mental and physical resources, predicted disability severity 28 years later among middle-aged municipal employees.
较低的职业阶层与晚年更高的残疾风险相关。然而，目前尚不清楚中年时期脑力和体力工作对个人资源的需求与晚年的幸福感之间是否存在关联。本研究前瞻性地调查了中年时期的工作能力是否可以预测老年时日常生活活动的残疾严重程度。
数据来自基于人群的 28 年随访研究，即芬兰市政雇员纵向研究。共有 2879 名 44-58 岁的在职人员在 1981 年基线时回答了一份关于工作能力的问卷，并在 2009 年回答了日常生活活动问卷。在基线时，根据相对于一生最佳状态的感知工作能力，将工作能力分为优秀、中等和较差。在随访时，根据自我护理日常生活活动（ADL）和工具性日常生活活动（IADL）报告的困难程度和频率，构建残疾量表。
根据优秀、中等和较差的中年工作能力，ADL 和 IADL 残疾严重程度呈现出分级的流行趋势（p<0.001）。与中年时具有优秀工作能力的人相比，中等工作能力的员工 ADL 或 IADL 残疾严重程度评分平均高出 11-20%，IRR 范围为 1.11（95% CI 1.01-1.22）至 1.20（95% CI 1.10-1.30）。而工作能力较差的人 ADL 或 IADL 残疾严重程度评分比参照组高 27-38%，IRR 范围为 1.27（95% CI 1.09-1.47）至 1.38（95% CI 1.25-1.53）。仅调整社会经济、生活方式因素和慢性疾病后，这些关联略有减弱。
工作能力是脑力和体力工作对个人心理和生理资源的需求与个人心理和生理资源之间的指标，可预测中年市政雇员 28 年后的残疾严重程度。
