A New Path to Address Multimorbidity? Longitudinal Analyses of Retirement Sequences and Chronic Diseases in Old Age

Abstract

Chronic disease and multimorbidity are growing health challenges for aging populations, often coinciding with retirement. We examine late-life predictors of multimorbidity, focusing on the association between retirement sequences and number of chronic diseases. We modeled the number of chronic diseases as a function of six types of previously identified 10-year retirement sequences using Health and Retirement Study (HRS) data for 7,880 Americans observed between ages 60 to 61 and 70 to 71. Our results show that at baseline, the adjusted prevalence of multimorbidity was lowest in sequences characterized by late retirement from full-time work and highest in sequences characterized by early labor-force disengagement. Age increases in multimorbidity varied across retirement sequences, though overall differences in prevalence persisted at age 70 to 71. Earlier life disadvantages did not moderate these associations. Findings suggest further investigation of policies that target health limitations affecting work, promote continued beneficial employment opportunities, and ultimately leverage retirement sequences as a novel path to influence multimorbidity in old age.

Keywords

noncommunicable disease work labor force career trajectory

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References

Aldington

Ecclestone

(2019). Evidence-based pain management: Building on the foundations of Cochrane systematic reviews. American Journal of Public Health, 109(1), 46–49. https://doi.org/10.2105/AJPH.2018.304745

Allel

León

A. S.

Staudinger

U. M.

Calvo

(2019). Healthy retirement begins at school: Educational differences in the health outcomes of early transitions into retirement. Ageing and Society, 41(1), 137–157. https://doi.org/10.1017/s0144686x19000928

Azar

Staudinger

U. M.

Slachevsky

Madero-Cabib

Calvo

(2019). From snapshots to movies: The association between retirement sequences and aging trajectories in limitations to perform activities of daily living. Journal of Aging and Health, 31(2), 293–321. https://doi.org/10.1177/0898264318782096

Boehmer

K. R.

Abu Dabrh

A. M.

Gionfriddo

M. R.

Erwin

Montori

V. M.

(2018). Does the chronic care model meet the emerging needs of people living with multimorbidity? A systematic review and thematic synthesis. PLOS ONE, 13(2), Article e0190852. https://doi.org/10.1371/journal.pone.0190852

Cabral

G. G.

Dantas

Souza

A. C.

Barbosa

I. R.

Jerez-Roig

Souza

D. L. B.

(2019). Multimorbidity and its impact on workers: A review of longitudinal studies. Safety and Health at Work, 10(4), 393–399. https://doi.org/10.1016/j.shaw.2019.08.004

Calvo

Madero-Cabib

Staudinger

U. M.

(2018). Retirement sequences of older Americans: Moderately destandardized and highly stratified across gender, class, and race. The Gerontologist, 58(6), 1166–1176. https://doi.org/10.1093/geront/gnx052

Calvo

Sarkisian

Tamborini

C. R.

(2013). Causal effects of retirement timing on subjective physical and emotional health. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 68(1), 73–84. https://doi.org/10.1093/geronb/gbs097

Cigolle

C. T.

Nagel

C. L.

Blaum

C. S.

Liang

Quinones

A. R.

(2018). Inconsistency in the self-report of chronic diseases in panel surveys: Developing an adjudication method for the Health and Retirement Study. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 73(5), 901–912. https://doi.org/10.1093/geronb/gbw063

De Boer

Geuskens

G. A.

Bultmann

Boot

C. R. L.

Wind

Koppes

L. L. J.

Frings-Dresen

M. H. W

. (2018). Employment status transitions in employees with and without chronic disease in the Netherlands. International Journal of Public Health, 63(6), 713–722. https://doi.org/10.1007/s00038-018-1120-8

10.

Delpierre

Barbosa-Solis

Torrisani

Darnaudery

Bartley

Blane

. . . Gustafsson

P. E.

(2016). Origins of heath inequalities: The case for allostatic load. Longitudinal and Life Course Studies, 7(1), 79–103. https://doi.org/10.14301/llcs.v7i1.325

11.

Dugravot

Fayosse

Dumurgier

Bouillon

Rayana

T. B.

Schnitzler

. . .Singh-Manoux

(2020). Social inequalities in multimorbidity, frailty, disability, and transitions to mortality: A 24-year follow-up of the Whitehall II cohort study. The Lancet Public Health, 5(1), e42–e50. https://doi.org/10.1016/S2468-2667(19)30226-9

12.

Fahy

A. E.

Stansfeld

S. A.

Smuk

Lain

Van der Horst

Vickerstaff

Clark

(2017). Longitudinal associations of experiences of adversity and socioeconomic disadvantage during childhood with labour force participation and exit in later adulthood. Social Science and Medicine, 183, 80–87. https://doi.org/10.1016/j.socscimed.2017.04.023

13.

Fisher

G. G.

Chaffee

D. S.

Sonnega

(2016). Retirement timing: A review and recommendations for future research. Work, Aging and Retirement, 2(2), 230–261. https://doi.org/10.1093/workar/waw001

14.

Glynn

L. G.

Valderas

J. M.

Healy

Burke

Newell

Gillespie

Murphy

A. W.

(2011). The prevalence of multimorbidity in primary care and its effect on health care utilization and cost. Family Practice, 28(5), 516–523. https://doi.org/10.1093/fampra/cmr013

15.

Hedström

Ylikoski

(2010). Causal mechanisms in the social sciences. Annual Review of Sociology, 36(1), 49–67. https://doi.org/10.1146/annurev.soc.012809.102632

16.

Henchoz

Seematter-Bagnoud

Nanchen

Bula

Von Gunten

Demonet

J. F.

Santos-Eggimann

(2019). Childhood adversity: A gateway to multimorbidity in older age? Archives of Gerontology and Geriatrics, 80, 31–37. https://doi.org/10.1016/j.archger.2018.10.003

17.

Hessel

(2016). Does retirement (really) lead to worse health among European men and women across all educational levels? Social Science and Medicine, 151, 19–26. https://doi.org/10.1016/j.socscimed.2015.12.018

18.

Humphreys

Jameson

Cooper

Dennison

(2018). Early-life predictors of future multi-morbidity: Results from the Hertfordshire Cohort. Age and Ageing, 47(3), 474–478. https://doi.org/10.1093/ageing/afy005

19.

Kingston

Robinson

Booth

Knapp

Jagger

, For the MODEM project (2018). Projections of multi-morbidity in the older population in England to 2035: Estimates from the Population Ageing and Care Simulation (PACSim) model. Age and Ageing, 47(3), 374–380. https://doi.org/10.1093/ageing/afx201

20.

Nugent

Bertram

M. Y.

Jan

Niessen

L. W.

Sassi

Jamison

D. T.

. . .Beaglehole

(2018). Investing in non-communicable disease prevention and management to advance the sustainable development goals. The Lancet, 391(10134), 2029–2035. https://doi.org/10.1016/s0140-6736(18)30667-6

21.

Nunes

B. P.

Flores

T. R.

Mielke

G. I.

Thume

Facchini

L. A.

(2016). Multimorbidity and mortality in older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 67, 130–138. https://doi.org/10.1016/j.archger.2016.07.008

22.

Pavela

Latham

(2016). Childhood conditions and multimorbidity among older adults. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 71(5), 889–901. https://doi.org/10.1093/geronb/gbv028

23.

Rowe

J. W.

Fulmer

Fried

(2016). Preparing for better health and health care for an aging population. JAMA: The Journal of the American Medical Association, 316(16), 1643–1644. https://doi.org/10.1001/jama.2016.12335

24.

Salive

M. E.

(2013). Multimorbidity in older adults. Epidemiologic Reviews, 35, 75–83. https://doi.org/10.1093/epirev/mxs009

25.

Staudinger

U. M.

Finkelstein

Calvo

Sivaramakrishnan

(2016). A global view on the effects of work on health in later life. The Gerontologist, 56(Suppl. 2), S281–S292. https://doi.org/10.1093/geront/gnw032

26.

Stenholm

Westerlund

Head

Hyde

Kawachi

Pentti

. . .Vahtera

(2015). Comorbidity and functional trajectories from midlife to old age: The Health and Retirement Study. The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences, 70(3), 332–338. https://doi.org/10.1093/gerona/glu113

27.

Stephan

Sutin

A. R.

Luchetti

Terracciano

(2016). Allostatic load and personality: A 4-year longitudinal study. Psychosomatic Medicine, 78(3), 302–310. https://doi.org/10.1097/PSY.0000000000000281

28.

Sullivan

T. R.

Salter

A. B.

Ryan

Lee

K. J.

(2015). Bias and precision of the “multiple imputation, then deletion” method for dealing with missing outcome data. American Journal of Epidemiology, 182(6), 528–534. https://doi.org/10.1093/aje/kwv100

29.

Vanajan

Bultmann

Henkens

(2020). Health-related work limitations among older workers—The role of flexible work arrangements and organizational climate. The Gerontologist, 60(3), 450–459. https://doi.org/10.1093/geront/gnz073

30.

Van Zon

S. K. R.

Reijneveld

S. A.

Galaurchi

Mendes de Leon

C. F.

Almansa

Bultmann

. (2020). Multimorbidity and the transition out of full-time paid employment: A longitudinal analysis of the health and retirement study. The Journals of Gerontology, Series B: Psychological Sciences and Social Sciences, 75(3), 705–715. https://doi.org/10.1093/geronb/gbz061

31.

Wei

M. Y.

Ratz

Mukamal

K. J.

(2020). Multimorbidity in Medicare beneficiaries: Performance of an ICD-coded multimorbidity-weighted index. Journal of the American Geriatrics Society, 68(5), 999–1006. https://doi.org/10.1111/jgs.16310

32.

Whitty

C. J. M.

MacEwen

Goddard

Alderson

Marshall

Calderwood

. . . Marx

(2020). Rising to the challenge of multimorbidity. British Medical Association, 368, Article 16964. https://doi.org/10.1136/bmj.l6964

33.

Willis

Staudinger

U. M.

Factor-Litvak

Calvo

(2019). Stress and salivary telomere length in the second half of life: A comparison of life-course models. Advances in Life Course Research, 39, 34–41. https://doi.org/10.1016/j.alcr.2019.02.001

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