Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany; German Center for Diabetes Research (DZD), Ingolstädter Landstr. 1, 85764 München-Neuherberg, Germany.
Institute of Health Economics and Health Care Management, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany.
Econ Hum Biol. 2020 Aug;38:100893. doi: 10.1016/j.ehb.2020.100893. Epub 2020 May 29.
Retirement is a major life event potentially associated with changes in relevant risk factors for cardiovascular and metabolic conditions. This study analyzes the effect of retirement on behavioral and biomedical risk factors for chronic disease, together with subjective health parameters using Southern German epidemiological data. We used panel data from the KORA cohort study, consisting of 11,168 observations for individuals 45-80 years old. Outcomes included health behavior (alcohol, smoking, physical activity), biomedical risk factors (body-mass-index (BMI), waist-to-hip ratio (WHR), glycosylated hemoglobin (HbA1c), total cholesterol/HDL quotient, systolic/diastolic blood pressure), and subjective health (SF12 mental and physical scales, self-rated health). We applied a parametric regression discontinuity design based on age thresholds for pension eligibility. Robust results after p-value corrections for multiple testing showed an increase in BMI in early retirees (at the age of 60) [β = 1.11, corrected p-val. < 0.05] and an increase in CHO/HDL in regular retirees (age 65) [β = 0.47, corrected p-val. < 0.05]. Stratified analyses indicate that the increase in BMI might be driven by women and low educated individuals retiring early, despite increasing physical activity. The increase in CHO/HDL might be driven by men retiring regularly, alongside an increase in subjective physical health. Blood pressure also increased, but the effect differs by retirement timing and sex and is not always robust to sensitivity analysis checks. Our study indicates that retirement has an impact on different risk factors for chronic disease, depending on timing, sex and education. Regular male, early female, and low educated retirees should be further investigated as potential high-risk groups for worsening risk factors after retirement. Future research should investigate if and how these results are linked: in fact, especially in the last two groups, the increase in leisure time physical activity might not be enough to compensate for the loss of work-related physical activity, leading thus to an increase in BMI.
退休是一个重要的生活事件,可能与心血管和代谢疾病相关的风险因素的变化有关。本研究使用德国南部的流行病学数据,分析了退休对慢性病行为和生物医学风险因素以及主观健康参数的影响。我们使用了 KORA 队列研究的面板数据,该数据包含了 11168 名 45-80 岁个体的观察结果。结果包括健康行为(饮酒、吸烟、体育活动)、生物医学风险因素(体重指数(BMI)、腰臀比(WHR)、糖化血红蛋白(HbA1c)、总胆固醇/高密度脂蛋白比值、收缩压/舒张压)和主观健康(SF12 心理和生理量表、自评健康)。我们采用了基于养老金资格年龄阈值的参数回归不连续性设计。经过多次测试的 p 值校正后,稳健的结果显示,提前退休者(60 岁)的 BMI 增加[β=1.11,校正后 p 值<0.05],而定期退休者(65 岁)的 CHO/HDL 增加[β=0.47,校正后 p 值<0.05]。分层分析表明,尽管体力活动增加,但 BMI 的增加可能是由提前退休的女性和低学历者驱动的。CHO/HDL 的增加可能是由定期退休的男性驱动的,同时主观身体健康状况也有所改善。血压也有所升高,但这种影响因退休时间和性别而异,且并不总是对敏感性分析检查具有稳健性。我们的研究表明,退休对不同的慢性病风险因素有影响,具体取决于时间、性别和教育程度。定期退休的男性、提前退休的女性和低学历者应作为退休后风险因素恶化的潜在高危人群进一步研究。未来的研究应调查这些结果是否以及如何相关:事实上,特别是在后两个群体中,休闲时间体力活动的增加可能不足以弥补工作相关体力活动的减少,从而导致 BMI 的增加。