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退休年龄和残疾状况作为晚年认知障碍的途径:来自与挪威人口登记处关联的挪威 HUNT 研究的证据。

Retirement age and disability status as pathways to later-life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers.

机构信息

Department for Physical Health and Aging, Norwegian Institute of Public Health, Oslo, Norway.

Norwegian National Centre of Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.

出版信息

Int J Geriatr Psychiatry. 2023 Jul;38(7):e5967. doi: 10.1002/gps.5967.

Abstract

BACKGROUND

Research shows that retirement age is associated with later-life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later-life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior to old-age pension eligibility) and those who retired via the standard pathway.

METHODS

The study sample comprised 7210 participants from the Norwegian Trøndelag Health Study (HUNT4 70+, 2017-2019) who had worked for at least one year in 1967-2019, worked until age 55+, and retired before HUNT4. Dementia and MCI were clinically assessed in HUNT4 70+ when participants were aged 69-85 years. Historical data on participants' retirement age and pathway were retrieved from population registers. We used multinomial regression to assess the dementia/MCI risk for women and men retiring via the disability pathway, or early (<67 years), on-time (age 67, old-age pension eligibility) or late (age 68+) via the standard pathway.

RESULTS

In our study sample, 9.5% had dementia, 35.3% had MCI, and 28.1% retired via the disability pathway. The disability retirement group had an elevated risk of dementia compared to the on-time standard retirement group (relative risk ratio [RRR]: 1.64, 95% CI 1.14-2.37 for women, 1.70, 95% CI 1.17-2.48 for men). MCI risk was lower among men who retired late versus on-time (RRR, 0.76, 95% CI 0.61-0.95).

CONCLUSION

Disability retirees should be monitored more closely, and preventive policies should be considered to minimize the dementia risk observed among this group of retirees.

摘要

背景

研究表明,退休年龄与晚年认知能力相关,但尚未充分区分退休途径。我们研究了通过残疾途径(在达到领取老年养恤金的资格之前领取残疾养恤金)和通过标准途径退休的人,退休年龄与晚年痴呆症和轻度认知障碍(MCI)的关系。

方法

本研究样本包括来自挪威特隆赫姆健康研究(HUNT4 70+,2017-2019 年)的 7210 名参与者,他们在 1967-2019 年期间至少工作过一年,工作至 55 岁以上,并在 HUNT4 之前退休。当参与者年龄在 69-85 岁时,在 HUNT4 70+中对痴呆症和 MCI 进行了临床评估。参与者的退休年龄和途径的历史数据从人口登记处检索。我们使用多项分类回归来评估通过残疾途径退休的女性和男性,或通过标准途径提前(<67 岁)、按时(67 岁,领取老年养恤金的资格)或推迟(68+岁)退休的女性和男性的痴呆症/MCI 风险。

结果

在我们的研究样本中,9.5%的人患有痴呆症,35.3%的人患有 MCI,28.1%的人通过残疾途径退休。与按时标准退休组相比,残疾退休组的痴呆风险更高(女性相对风险比 [RRR]:1.64,95%置信区间 1.14-2.37,男性 1.70,95%置信区间 1.17-2.48)。与按时退休相比,男性中退休较晚的 MCI 风险较低(RRR,0.76,95%置信区间 0.61-0.95)。

结论

应更密切地监测残疾退休人员,并应考虑采取预防政策,以尽量减少观察到的该组退休人员的痴呆风险。

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