Nara Prefectural Health Research Center, Nara Medical University, Nara, Japan.
Geriatr Gerontol Int. 2018 Feb;18(2):308-314. doi: 10.1111/ggi.13184. Epub 2017 Nov 2.
Evidence regarding the health effects of working lack coherence. This study seeks to determine if continuing to work into older age benefits or damages one's health.
Baseline questionnaires were mailed to 15 058 individuals aged ≥65 years living in two municipalities in Nara Prefecture, Japan. Of these, 11 183 were returned. Analyses were limited to those who maintained each health index at baseline. We followed the participants for 3 years, and examined three health outcomes: long-term care need, cognitive decline and instrumental activities of daily living (IADL) decline. Participants were divided into four groups according to their baseline working status and follow-up status: non-working, retired, initiating work and continuing to work.
After covariate adjustments, older men who initiated work had a decreased likelihood for long-term care (odds ratio [OR] 0.41, 95% confidence interval [CI] 0.17-0.98) and IADL decline (OR 0.44, 95% CI 0.23-0.84), older men who continued working prevented the onset of long-term care (OR 0.22, 95% CI 0.09-0.54) and cognitive decline (OR 0.69, 95% CI 0.50-0.96), older women who initiated working were less likely to require long-term care (OR 0.24, 95% CI 0.09-0.66) and IADL decline (OR 0.38, 95% CI 0.16-0.88), and older women who continued working had a significantly lower risk of IADL decline (OR 0.39, 95% CI 0.16-0.99), compared with the non-working group. Retirees did not differ from the non-working group in any of the health outcomes.
Although beneficial effects vary by sex and type of health outcomes, the present findings suggest that policies encouraging older people to participate in the workforce contribute to extending healthy life expectancy. Geriatr Gerontol Int 2018; 18: 308-314.
关于工作对健康影响的证据缺乏连贯性。本研究旨在确定继续工作到老年是有益于还是损害健康。
向居住在日本奈良县两个市的 15058 名 65 岁及以上的人邮寄了基线调查问卷。其中 11183 人回复。分析仅限于那些在基线时保持每个健康指标的人。我们对参与者进行了 3 年的随访，并检查了 3 个健康结果：长期护理需求、认知能力下降和日常生活活动能力（IADL）下降。参与者根据其基线工作状况和随访状况分为四组：不工作、退休、开始工作和继续工作。
在调整了协变量后，开始工作的老年男性发生长期护理需求的可能性降低（比值比 [OR] 0.41，95%置信区间 [CI] 0.17-0.98）和 IADL 下降（OR 0.44，95% CI 0.23-0.84），继续工作的老年男性预防了长期护理需求的发生（OR 0.22，95% CI 0.09-0.54）和认知能力下降（OR 0.69，95% CI 0.50-0.96），开始工作的老年女性发生长期护理需求（OR 0.24，95% CI 0.09-0.66）和 IADL 下降（OR 0.38，95% CI 0.16-0.88）的可能性降低，而继续工作的老年女性 IADL 下降的风险显著降低（OR 0.39，95% CI 0.16-0.99），与不工作组相比。退休人员在任何健康结果方面与不工作组均无差异。
尽管受益效果因性别和健康结果类型而异，但本研究结果表明，鼓励老年人参与劳动力市场的政策有助于延长健康预期寿命。
