Department of Family Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan.
Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan.
Int J Environ Res Public Health. 2022 May 27;19(11):6553. doi: 10.3390/ijerph19116553.
With the aging of populations worldwide, the extension of people's working lives has become a crucial policy issue. The aim of this study is to assess the impact of complex multimorbidity (CMM) as a predictor of working status among retirement-aged adults in Japan.
Using a nationwide longitudinal cohort study of people aged over 65 who were free of documented disability at baseline, we matched individuals with respect to their propensity to develop CMM. The primary outcome of the study was working status after the six-year follow-up.
Among 5613 older adults (mean age: 74.2 years) included in the study, 726 had CMM and 2211 were still working at the end of the follow-up. In propensity-matched analyses, the employment rate was 6.4% higher in the CMM-free group at the end of the six-year follow-up compared to the CMM group (725 pairs; 29.5% vs. 35.9%; = 0.012). Logistic regression analysis showed that CMM prevented older people from continuing to work beyond retirement age and was a more important factor than socioeconomic factors (income or educational attainment) or psychological factors (depressive symptoms or purpose in life).
Our study found that CMM has an adverse impact on the employment rate of older adults in Japan. This finding suggests that providing appropriate support to CMM patients may extend their working lives.
随着全球人口老龄化，延长人们的工作寿命已成为一个关键的政策问题。本研究旨在评估复杂多重疾病（CMM）作为预测日本退休年龄成年人工作状态的指标的影响。
我们使用了一项针对 65 岁以上人群的全国性纵向队列研究，这些人在基线时没有记录残疾。我们根据发生 CMM 的倾向对个体进行了匹配。研究的主要结局是六年后的工作状态。
在纳入的 5613 名老年人（平均年龄：74.2 岁）中，726 人患有 CMM，2211 人在随访结束时仍在工作。在倾向评分匹配分析中，与 CMM 组相比，无 CMM 组在六年后的随访结束时的就业率高出 6.4%（725 对；29.5% vs. 35.9%； = 0.012）。逻辑回归分析表明，CMM 阻止老年人在退休年龄后继续工作，而且比社会经济因素（收入或教育程度）或心理因素（抑郁症状或生活目标）更为重要。
我们的研究发现，CMM 对日本老年人的就业率有不利影响。这一发现表明，为 CMM 患者提供适当的支持可能会延长他们的工作寿命。
