Nilsen Charlotta, Agerholm Janne, Kelfve Susanne, Wastesson Jonas W, Kåreholt Ingemar, Nabe-Nielsen Kirsten, Meinow Bettina
Stress Research Institute, Stockholm University, Sweden.
Aging Research Center, Karolinska Institutet/Stockholm University, Sweden.
Scand J Public Health. 2024 Aug;52(6):726-732. doi: 10.1177/14034948231188999. Epub 2023 Aug 3.
There is substantial evidence that previous working conditions influence post-retirement health, yet little is known about previous working conditions' association with old-age dependency. We examined job strain, hazardous and physical demands across working life, in relation to the risk of entering old-age dependency of care.
Individually linked nationwide Swedish registers were used to identify people aged 70+ who were not receiving long-term care (residential care or homecare) at baseline (January 2014). Register information on job titles between the years 1970 and 2010 was linked with a job exposure matrix of working conditions. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Cox regression models with age as the timescale (adjusted for living situation, educational attainment, country of birth, and sex) were conducted to estimate hazard ratios for entering old-age dependency during the 24 months of follow-up ( = 931,819).
Having initial adverse working conditions followed by an accumulation throughout working life encompassed the highest risk of entering old-age dependency across the categories (job strain: HR 1.23, 95% CI 1.19-1.27; physical demands: HR 1.36, 95% CI 1.31-1.40, and hazardous work: HR 1.35, 95% CI 1.30-1.40). Initially high physical demands or hazardous work followed by a stable trajectory, or initially low-level physical demand or hazardous work followed by an accumulation throughout working life also encompassed a higher risk of dependency.
A history of adverse working conditions increased the risk of old-age dependency. Reducing the accumulation of adverse working conditions across the working life may contribute to postponing old-age dependency.
有大量证据表明，以前的工作条件会影响退休后的健康状况，但对于以前的工作条件与老年生活依赖之间的关联却知之甚少。我们研究了整个工作生涯中的工作压力、危险和体力要求与进入老年护理依赖风险之间的关系。
使用瑞典全国范围内的个人关联登记册，识别出在基线时（2014年1月）未接受长期护理（机构护理或家庭护理）的70岁及以上人群。1970年至2010年期间的职位登记信息与工作条件的工作暴露矩阵相关联。使用随机效应增长曲线模型来计算工作条件的个体内轨迹。采用以年龄为时间尺度的Cox回归模型（根据生活状况、教育程度、出生国家和性别进行调整），以估计在24个月随访期间进入老年护理依赖的风险比（n = 931,819）。
最初工作条件不利，随后在整个工作生涯中不断累积，在各类别中进入老年护理依赖的风险最高（工作压力：风险比1.23，95%置信区间1.19 - 1.27；体力要求：风险比1.36，95%置信区间1.31 - 1.40，危险工作：风险比1.35，95%置信区间1.30 - 1.40）。最初体力要求高或从事危险工作，随后轨迹稳定，或者最初体力要求或危险工作水平低，随后在整个工作生涯中不断累积，也包含较高的依赖风险。
不利的工作条件史会增加老年护理依赖的风险。减少整个工作生涯中不利工作条件的累积可能有助于推迟老年护理依赖。
