Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar 8;183(4):E235-42.
doi: 10.1503/cmaj.100713. Epub 2011 Jan 31.

Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study

Mikaela B von Bonsdorff  1 , Jorma Seitsamo, Juhani Ilmarinen, Clas-Håkan Nygård, Monika E von Bonsdorff, Taina Rantanen
Affiliations

Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study

Mikaela B von Bonsdorff et al. CMAJ. .

Abstract

Background: Poor work ability correlates with increased morbidity and early retirement from the workforce, but the association in old age is not known. We investigated work ability in midlife among white-collar and blue-collar employees as a predictor of mortality and disability 28 years later.

Methods: A total of 5971 occupationally active people aged 44-58 years participated in the Finnish Longitudinal Study of Municipal Employees (FLAME) in 1981. Perceived work ability relative to lifetime best was categorized as excellent, moderate or poor. In 2009, the ability to perform activities of daily living was assessed among 2879 respondents (71.0% of the survivors). Mortality data were available up to July 2009.

Results: At the 28-year follow-up, 1918 of the 5971 participants had died and 1403 had some form of disability. Rates of death per 1000 person-years among white-collar men were 7.7 for those with excellent work ability, 14.7 for those with moderate work ability and 23.5 for those with poor work ability. Among blue-collar men, the corresponding rates were 15.5, 20.2 and 25.3. In women, rates ranged between 6.3 and 10.6 per 1000 person-years. The age-adjusted hazard ratios (HRs) for mortality were two to three times higher among blue-collar male employees with lower work ability than among white-collar male employees with excellent work ability in midlife (i.e., the reference group). The odds of death or disability at follow-up compared with white-collar workers with excellent work ability were highest among blue-collar employees with poor work ability in midlife (odds ratio [OR] 4.56, 95% confidence interval [CI] 2.82-7.37 for men; OR 3.37, 95% CI 2.28-4.98 for women). Among the survivors, similar but slightly lower risks of disability 28 years later were found.

Interpretation: Perceived poor work ability in midlife was associated with accelerated deterioration in health and functioning and remains evident after 28 years of follow-up.

PubMed Disclaimer

References

    1. Marmot MG, Smith GD. Health inequalities among British civil servants: the Whitehall II study. Lancet 1991;337:1387–93 - PubMed
    1. Davey Smith G, Hart C, Hole D, et al. Education and occupational social class: Which is the more important indicator of mortality risk? J Epidemiol Community Health 1998;52:153–60 - PMC - PubMed
    1. Sacker A, Bartley MJ, Frith D, et al. The relationship between job strain and coronary heart disease: evidence from an English sample of the working male population. Psychol Med 2001; 31:279–90 - PubMed
    1. Huisman M, Kunst AE, Bopp M, et al. Educational inequalities in cause-specific mortality in middle-aged and older men and women in eight western European countries. Lancet 2005; 365:493–500 - PubMed
    1. Breeze E, Fletcher AE, Leon DA, et al. Do socio-economic disadvantages persist into old age? Self-reported morbidity in a 20-year follow-up of the Whitehall Study. Am J Public Health 2001;91:277–83 - PMC - PubMed

Publication types