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Background: Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement. Methods: This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension. Results: During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p,0.001) respectively. Conclusions: A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.

OBJECTIVE-Little is known about the association of leisure-time physical activity (LTPA) and cardiorespiratory fitness with development of the metabolic syndrome, which predisposes diseases such as diabetes and atherosclerosis. We studied the associations of LTPA and cardiorespiratory fitness with development of the metabolic syndrome (World Health Organization [WHO] and the National Cholesterol Education Program [NCEP] definitions). RESEARCH DESIGN AND METHODS-LTPA over the previous 12 months, VO 2max (ml ⅐ kg Ϫ1 ⅐ min Ϫ1), and cardiovascular and metabolic risk factors were assessed in a populationbased cohort of 612 middle-aged men without the metabolic syndrome. RESULTS-At the 4-year follow-up, 107 men had metabolic syndrome (WHO definition). Men engaging in Ͼ3 h/week of moderate or vigorous LTPA were half as likely as sedentary men to have the metabolic syndrome after adjustment for major confounders (age, BMI, smoking, alcohol, and socioeconomic status) or potentially mediating factors (insulin, glucose, lipids, and blood pressure), especially in high-risk men. Vigorous LTPA had an even stronger inverse association, particularly in unfit men. Men in the upper third of VO 2max were 75% less likely than unfit men to develop the metabolic syndrome, even after adjustment for major confounders. Adjustment for possible mediating factors attenuated the association. Associations of LTPA and VO 2max with development of the metabolic syndrome, as defined by the NCEP, were qualitatively similar. CONCLUSIONS-In particular, high-risk men engaging in currently recommended levels of physical activity were less likely to develop the metabolic syndrome than sedentary men. Cardiorespiratory fitness was also strongly protective, although possibly not independent of mediating factors.

Physical activity at work and in leisure time was studied by using a questionnaire in a random population sample from two counties of Eastern Finland in 1972. Data on age, serum cholesterol, diastolic blood pressure, height, weight and smoking were recorded in a field examination. The study population consisted of 3978 men aged 30-59 years and 3688 women aged 35-59 years. The participation rate was 92% in men and 94% in women in these age groups. During the approximately seven-year follow-up until December 31, 1978, 210 men and 63 women had an acute myocardial infarction (AMI), 89 men and 14 women died of acute ischemic heart disease, 71 men and 56 women had a cerebral stroke and 172 men and 75 women died of any disease. The subjects with a history of myocardial infarction, angina or cerebral stroke in the 12 months preceding the baseline survey were excluded in the respective analysis. Low physical activity at work was associated with an increased risk of AMI, cerebral stroke and death due to any disease in both men and women, even when controlling for age, serum total cholesterol, diastolic blood pressure, height, weight and smoking in a multiple logistic model. The relative risk of AMI was 1.5 (90% confidence interval (CI) = 1.2-2.0) in men and 2.4 (90% CI = 1.5-3.7) in women. Low physical activity in leisure time had a significant association with an increased risk of death, but not with an increased risk of AMI or stroke in the multivariate analysis.