Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing

Abstract

BackgroundGiven the acceleration of population ageing and policy changes to extend working lives, evidence is needed on the ability of older adults to work for longer. To understand more about the health impacts of work, this study examined the relationship between employment histories before retirement and trajectories of frailty thereafter.MethodsThe sample comprised 2765 women and 1621 men from the English Longitudinal Study of Ageing. We used gendered typologies of life-time employment and a frailty index (FI). Multilevel growth curve models were used to predict frailty trajectories by employment histories.ResultsWomen who had a short break for family care, then did part-time work till 59 years had a lower FI after 60 years than those who undertook full-time work until 59 years. Women who were largely family carers or non-employed throughout adulthood, had higher levels of frailty at 60 years but experienced a slower decline with age. Men who worked full-time but early exited at either 49 or 60 years had a higher FI at 65 years than those who worked full-time up to 65 years. Interaction between employment histories and age indicated that men in full-time work who experienced an early exit at 49 tended to report slower declines.ConclusionsFor women, experiencing distinct periods throughout the lifecourse of either work or family care may be advantageous for lessening frailty risk in later life. For men, leaving paid employment before 65 years seems to be beneficial for decelerating increases in frailty thereafter. Continuous full-time work until retirement age conferred no long-term health benefits.

Trajectories of Accumulation of Health Deficits in Older Adults: Are There Variations According to Health Domains?

“…Over the past years, an increasing number of longitudinal studies have evaluated trajectories of health deficits accumulation (DA) in older adults and their main determinants [3][4][5][6][7][8][9]. Most of these studies have relied on the frailty index, a multidimensional index defined as the proportion of health deficits present in an individual out of the total number of deficits considered, which has shown to be a good predictor of adverse outcomes (i.e., falls, hospitalization, disability, institutionalization and death) in older adults [10].…”

Do work and family care histories predict health in older women?

“…self-rated health, mortality or frailty), the methods used to identify and summarize lifecourse patterns, and the country considered (USA or England), these studies have reached varying conclusions on whether work–family histories predict differences in later life health. 10 , 13 , 17 Lu et al . , 17 examining frailty trajectories among English women aged 60+, reported beneficial effects for those who took a short career break before returning to work part-time compared with women who worked mostly full-time throughout (FTT).…”

“… 10 , 13 , 17 Lu et al . , 17 examining frailty trajectories among English women aged 60+, reported beneficial effects for those who took a short career break before returning to work part-time compared with women who worked mostly full-time throughout (FTT). In American mothers aged 55+, Sabbath et al 13 found lower mortality in those who returned to work after briefly staying home with children compared with non-workers, always workers and those who delayed work re-entry.…”

Sickness absence trajectories following labour market participation patterns: a cohort study in Catalonia (Spain), 2012–2014

“…Traditionally, for health and health-related outcomes, occupational epidemiology has assessed exposure-outcome association measures, whether simple or accumulated, at one point in time. Few studies have involved longitudinal analyses of the effect of prior working life on health [11][12][13][14][15][16]. From the standpoint of occupational epidemiology, because a person lives in a multidimensional and multilevel context, an approach from a lifecourse perspective could elucidate relevant events in a person's working life that manifest and shape health status over time [17].…”