Prior sick leave with mental or somatic diagnoses and being in work in ages 66–71; a Swedish cohort

Abstract Background As longevity and retirement ages are increasing, knowledge is needed on factors hindering extended working lives. The aim of this study was to explore how sickness absence (SA) and disability pension (DP) due to mental and/or somatic diagnoses before age 65 were associated with being in paid work when aged 66-71. Methods A 6-year prospective population-based cohort study of all 98,551 people (48% women) in Sweden who turned 65 years in 2010 (baseline year) and had been in paid work at any point when aged 60-64. Microdata from nationwide registers were used. Exposure variables were SA (spells >14 days) and/or DP in 2005-2009, and the outcome variable was paid work at any point in 2011-2016. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI) for associations between exposures and outcome, controlling for sociodemographic factors in 2010, stratified by sex. Results Most women (56.0%) and men (66.3%) had no SA or DP when aged 60-64. Of the women, 42.7% and of the men 53.3% were in paid work after the age of 65. Those with SA due to mental diagnoses had lower OR of being in paid work (women 0.76; 95% CI: 0.69-0.84; men 0.74; 0.65-0.84). This association was weaker for SA due to somatic diagnoses (women 0.87; 0.84-0.91; men 0.92; 0.89-0.96). Having had SA due to both mental and somatic diagnoses was associated with lower OR for men (0.77; 0.65-0.91) but not women (0.98; 0.88-1.09). Full- or part-time DP had the strongest association with not being in paid work regardless of diagnosis group and sex (e.g., women mental DP 0.39; 0.34-0.45; women somatic DP 0.38; 0.35-0.41; men mental DP 0.36; 0.29-0.43; men somatic DP 0.35; 0.32-0.38). Conclusions SA due to mental diagnoses had a stronger association with not being in paid work after age 65 than SA due to somatic diagnoses. The results highlight the importance of identifying factors that hinder older workers with mental disorders to extend their working lives. Key messages Many were in paid work after age 65, also among those with previous SA. However, this was less likely among those who had been on SA due to mental diagnoses compared to somatic diagnoses. More knowledge is needed on how older people with different types of mental and somatic morbidities can extend their working lives, what hinders and what promotes this in different European countries.


Background:
As longevity and retirement ages are increasing, knowledge is needed on factors hindering extended working lives. The aim of this study was to explore how sickness absence (SA) and disability pension (DP) due to mental and/or somatic diagnoses before age 65 were associated with being in paid work when aged 66-71. Methods: A 6-year prospective population-based cohort study of all 98,551 people (48% women) in Sweden who turned 65 years in 2010 (baseline year) and had been in paid work at any point when aged 60-64. Microdata from nationwide registers were used. Exposure variables were SA (spells >14 days) and/or DP in [2005][2006][2007][2008][2009], and the outcome variable was paid work at any point in 2011-2016. Logistic regression was used to calculate odds ratios (OR) with 95% confidence intervals (CI) for associations between exposures and outcome, controlling for sociodemographic factors in 2010, stratified by sex.

Results:
Most women (56.0%) and men (66.3%) had no SA or DP when aged 60-64. Of the women, 42.7% and of the men 53.3% were in paid work after the age of 65. Those with SA due to mental diagnoses had lower OR of being in paid work (women 0.76; 95% CI: 0.69-0.84; men 0.74; 0.65-0.84). This association was weaker for SA due to somatic diagnoses (women 0.87; 0.84-0.91; men 0.92; 0.89-0.96). Having had SA due to both mental and somatic diagnoses was associated with lower OR for men (0.77; 0.65-0.91) but not women (0.98; 0.88-1.09). Full-or part-time DP had the strongest association with not being in paid work regardless of diagnosis group and sex (e.g., women mental DP 0.39; 0.34-0.45; women somatic DP 0.38; 0.35-0.41; men mental DP 0.36; 0.29-0.43; men somatic DP 0.35; 0.32-0.38). Conclusions: SA due to mental diagnoses had a stronger association with not being in paid work after age 65 than SA due to somatic diagnoses. The results highlight the importance of identifying factors that hinder older workers with mental disorders to extend their working lives. Key messages: Many were in paid work after age 65, also among those with previous SA. However, this was less likely among those who had been on SA due to mental diagnoses compared to somatic diagnoses.

Background:
Increasing the labour market participation of people with a reduced ability to work is a big labour market challenge in many countries. In Finland, one third of all new disability pensions are granted as partial pensions. It is also known that most partial disability pensioners continue working while receiving a pension. There is only limited research about the length of employment of partial disability pensioners and the factors associated with employment in retirement. The aim of this study was to examine the employment at the onset of partial disability retirement and four years after retirement, and to examine how age, gender, educational level, employment sector, diagnosis and type of pension are associated with employment after partial disability retirement.

Methods:
Our Finnish register data comprised 7,617 partial disability pensioners aged 20-58 who retired in 2013 or 2014. Logistic and multinomial logistic regression analysis were used to estimate OR:s and 95 percent CI:s for employment at the onset of partial disability retirement and four years after retirement.
Results: 81 percent of partial disability pensioners were employed when retiring on a partial disability pension. Four years later, 50 percent were still drawing a partial disability pension, of whom 77 percent were working. 11 percent were employed but no longer drawing a partial disability pension. The partial disability pensioners who were more often employed were younger, female, more highly educated, working in the public sector and receiving a temporary disability pension.

Conclusions:
Many sociodemographic factors are associated with employment at the onset of partial disability retirement and with continued working while drawing a partial disability pension. Key messages: Employment after partial disability retirement is common and relatively stable. After four years of retirement, more than 70 percent of partial disability pensioners were still working. Many sociodemographic factors are associated with employment after partial disability retirement.