Palmer Keith T, D'Angelo Stefania, Harris E Clare, Linaker Cathy, Gale Catharine R, Evandrou Maria, Syddall Holly, van Staa Tjeerd, Cooper Cyrus, Aihie Sayer Avan, Coggon David, Walker-Bone Karen
MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
Occup Environ Med. 2017 Jul;74(7):476-482. doi: 10.1136/oemed-2016-104103. Epub 2017 Jan 6.
Demographic changes are requiring people to work longer. No previous studies, however, have focused on whether the 'frailty' phenotype (which predicts adverse events in the elderly) is associated with employment difficulties. To provide information, we assessed associations in the Health and Employment After Fifty Study, a population-based cohort of 50-65-year olds.
Subjects, who were recruited from 24 English general practices, completed a baseline questionnaire on 'prefrailty' and 'frailty' (adapted Fried criteria) and several work outcomes, including health-related job loss (HRJL), prolonged sickness absence (>20 days vs less, past 12 months), having to cut down substantially at work and difficulty coping with work's demands. Associations were assessed using logistic regression and population attributable fractions (PAFs) were calculated.
In all, 3.9% of 8095 respondents were classed as 'frail' and 31.6% as 'prefrail'. Three-quarters of the former were not in work, while 60% had left their last job on health grounds (OR for HRJL vs non-frail subjects, 30.0 (95% CI 23.0 to 39.2)). Among those in work, ORs for prolonged sickness absence, cutting down substantially at work and struggling with work's physical demands ranged from 10.7 to 17.2. The PAF for HRJL when any frailty marker was present was 51.8% and that for prolonged sickness absence was 32.5%. Associations were strongest with slow reported walking speed. Several associations were stronger in manual workers than in managers.
Fried frailty symptoms are not uncommon in mid-life and are strongly linked with economically important adverse employment outcomes. Frailty could represent an important target for prevention.
人口结构的变化要求人们延长工作年限。然而，此前尚无研究关注“衰弱”表型（可预测老年人不良事件）是否与就业困难相关。为提供相关信息，我们在“五十岁后的健康与就业研究”中评估了两者的关联，该研究是以50至65岁人群为基础的队列研究。
从24家英国普通诊所招募的受试者完成了一份关于“衰弱前期”和“衰弱”（采用弗里德标准改编）的基线问卷以及多项工作相关结果的问卷，包括与健康相关的失业（HRJL）、长期病假（过去12个月中>20天与少于20天相比）、不得不大幅减少工作量以及难以应对工作要求。使用逻辑回归评估关联，并计算人群归因分数（PAF）。
在8095名受访者中，总计3.9%被归类为“衰弱”，31.6%为“衰弱前期”。前者中有四分之三没有工作，而其中60%因健康原因辞去了上一份工作（与非衰弱受试者相比，HRJL的比值比为30.0（95%置信区间23.0至39.2））。在有工作的人群中，长期病假、大幅减少工作量以及难以应对工作体力要求的比值比在10.7至17.2之间。存在任何衰弱标志物时，HRJL的PAF为51.8%，长期病假的PAF为32.5%。与报告的步行速度缓慢的关联最为强烈。体力劳动者中的几种关联比管理人员更强。
弗里德衰弱症状在中年并不罕见，且与具有经济重要性的不良就业结果密切相关。衰弱可能是一个重要的预防目标。
