Body mass index and the risk of disability retirement: a systematic review and meta-analysis

Abstract

The aim of this study was to determine the associations of body mass index (BMI) with all-cause and cause-specific disability retirement. Literature searches were conducted in PubMed, Embase and Web of Science from their inception to May 2019. A total of 27 (25 prospective cohort and 2 nested case-control) studies consisting of 2 199 632 individuals qualified for a meta-analysis. Two reviewers independently assessed the methodological quality of the included studies. We used a random effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses. There were a large number of participants and the majority of studies were rated at low or moderate risk of bias. There was a J-shaped relationship between BMI and disability retirement. Underweight (hazard ratio (HR)/risk ratio (RR)=1.20, 95% CI 1.02 to 1.41), overweight (HR/RR=1.13, 95% CI 1.07 to 1.19) and obese individuals (HR/RR=1.52, 95% CI 1.36 to 1.71) were more commonly granted all-cause disability retirement than normal-weight individuals. Moreover, overweight increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.26, 95% CI 1.15 to 1.39) and cardiovascular diseases (HR=1.73, 95% CI 1.24 to 2.41), and obesity increased the risk of disability retirement due to musculoskeletal disorders (HR/RR=1.66, 95% CI 1.42 to 1.94), mental disorders (HR=1.29, 95% CI 1.04 to 1.61) and cardiovascular diseases (HR=2.80, 95% CI 1.85 to 4.24). The association between excess body mass and all-cause disability retirement did not differ between men and women and was independent of selection bias, performance bias, confounding and adjustment for publication bias. Obesity markedly increases the risk of disability retirement due to musculoskeletal disorders, cardiovascular diseases and mental disorders. Since the prevalence of obesity is increasing globally, disease burden associated with excess body mass and disability retirement consequently are projected to increase. Reviewregistrationnumber: CRD42018103110.

Prevalence of work related musculoskeletal disorders in Italian workers: is there an underestimation of the related occupational risk factors?

“…In accordance to our data, BMI was also associated with musculoskeletal symptoms of the lower extremity [27]. Furthermore, obesity markedly increases the risk of disability retirement due to WMSDs [28].…”

Body Mass Index (BMI) and Work Ability in Older Workers: Results from the Health and Employment after Fifty (HEAF) Prospective Cohort Study

“…A meta-analysis of 28 studies reported that the relative risk of disability pensioning was 1.53 for individuals with obesity and 1.16 for those overweight [35]. Similar results were reported more recently in a meta-analysis in which the outcome was "disability retirement" and which demonstrated that obesity was also associated with disability retirement caused by musculoskeletal disorders, cardiovascular diseases, and mental disorders [36]. Unfortunately, fundamental differences in the structuring of welfare systems make comparison unfeasible between countries regarding disability pensioning and disability retirement.…”

Indicators and determinants of the years of working life lost: a narrative review

“…People who were physically active for at least 2 days a week were more likely to work beyond retirement age [45]. Disability retirement is more common in people with overweight or obesity [46], in smokers [42,47] and in those who are inactive during their leisure time [48] compared with normal weight, never smokers or active individuals, respectively.…”