Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife.
Abstract Background We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). Methods Subjects who responded MLs questionnaires (1985–2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectorie…
Work strain in midlife and 28-year work ability trajectories
We investigated the 28-year development trajectories of work ability among initially middle-aged male and female municipal employees and the association of perceived mental and physical work strain in midlife by work ability trajectory groups.The baseline data of the Finnish longitudinal study of municipal employees (FLAME) were collected in 1981 (N=6257) with follow-ups in 1985, 1992, 1997, and 2009. Work ability was assessed in all the waves as present perceived work ability relative to lifetime best. Altogether, N=2690 had work ability data in 1981 and 2009, and at least for one wave in between these years, and were included in group-based semi-parametric mixture modeling trajectory anal…
Work ability in midlife as a predictor of mortality and disability in later life: a 28-year prospective follow-up study.
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 availab…
Work-related biomechanical exposure and job strain in midlife separately and jointly predict disability after 28 years: a Finnish longitudinal study
Objectives We investigated whether the extent of biomechanical exposures and job strain in midlife separately and jointly predict disability in old age. Methods Participants of the Finnish Longitudinal Study on Aging Municipal Employees (FLAME) in 1981 (aged 44–58 years) responded to disability questionnaires in 2009 (1850 women and 1082 men). Difficulties in performing five activities of daily living (ADL) and seven instrumental ADL (IADL) were used to assess severity of disability (score range: 0–12, 0=no disability). Information on biomechanical exposures and job strain was collected by questionnaire at baseline. Adjusted prevalence proportion ratios (PR) and 95% confidence intervals (95…
Job strain in the public sector and hospital in-patient care use in old age : a 28-year prospective follow-up
Background: high job strain increases the risk of health decline, but little is known about the specific consequences and long-term effects of job strain on old age health. Objectives: purpose was to investigate whether physical and mental job strain in midlife was associated with hospital care use in old age. Methods: study population included 5,625 Finnish public sector employees aged 44–58 years who worked in blue- and white-collar professions in 1981. The number of in-patient hospital care days was collected from the Finnish Hospital Discharge Register for the 28-year follow-up period. Results: rates of hospital care days per 1,000 person-years for men were 7.78 (95% confidence interval…
Type of retirement as a determinant of pre- and post-retirement hospital in-patient care use: a prospective study
Background We examined prospectively the use of all-cause hospital in-patient care among public sector employees by using a 3-year pre- and post-retirement study window. Methods A total of 5269 participants of the Finnish Longitudinal Study of Municipal Employees had retired during January 1984 and July 2000. They had register-based data on retirement (non-disability retirement n = 3411, men 40%, and diagnose-specific disability retirement n = 1858, men 50%) and all-cause hospital in-patient admissions and discharges. Analyses were conducted using Generalized Estimating Equation model. Results The prevalence of hospital care use for non-disability retirees remained stable during the 6-year …
Lifestyle counseling in overweight truck and bus drivers : Effects on dietary patterns and physical activity
We studied dietary patterns, physical activity (PA), and monthly goal setting in a weight reduction intervention in long-distance professional drivers. The study was conducted in Finland in 2009–2012. Male drivers with waist circumference > 100 cm were randomized to a lifestyle counseling (LIFE, N = 55) and a reference (REF, N = 58) group. During 12 months, LIFE participated in 6 face-to-face and 7 telephone counseling sessions on diet and PA. Dietary patterns were assessed using an index combining food diary and counselor interview, and PA with the number of daily steps using a pedometer. Monthly lifestyle goals, perceived facilitators and barriers, and adverse effects of PA in the LIFE pa…
Perceived stress symptoms in midlife predict disability in old age: a 28-year prospective cohort study.
Background Stress has damaging effects on individual's health. However, information about the long-term consequences of mental stress is scarce. Methods This 28-year prospective cohort study examined on the associations between midlife stress and old age disability among 2,994 Finnish municipal professionals aged 44-58 years at baseline. Self-reported stress symptoms were assessed at baseline in 1981 and 4 years later in 1985 and perceived disability in 2009. For the baseline data, principal component analysis was used for differentiation into stress symptom profiles. The regression coefficient estimates for self-care disability (activities of daily living) and instrumental activities of da…
Muscle strength and muscle endurance of middle-aged women and men associated to type, duration and intensity of muscular load at work
Muscle strength and muscle endurance in groups with different occupational muscular load was studied among 60 women and 69 men. The mean age of the subjects was 52.0 +/- 3.4 years. Isometric grip and trunk strength were measured on dynamometers, and dynamic muscle endurance by sit-ups. A job analysis was done with the AET method including the assessment of intensity, duration and type of muscular work of each subject. According to the job analysis, the subjects were classified into groups with low or high muscular load at work. The maximal isometric hand grip strength of women with a load classified as long duration of static or dynamic load on the hands at work was 86 and 88%, respectively…
Trajectories of mobility limitations over 24 years and their characterization by shift work and leisure-time physical activity in midlife
Background We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). Methods Subjects who responded MLs questionnaires (1985–2009, N = 3048) in Finnish Longitudinal Study on Aging Municipal Employees were included in this prospective cohort study. LTPA and shift work were measured during baseline. International Classification of Functioning was used to code MLs. Growth mixture modeling was used to identify the trajectories of MLs.…
Job strain among blue-collar and white-collar employees as a determinant of total mortality: a 28-year population-based follow-up.
Objectives To investigate the effect of job demand, job control and job strain on total mortality among white-collar and blue-collar employees working in the public sector. Design 28-year prospective population-based follow-up. Setting Several municipals in Finland. Participants 5731 public sector employees from the Finnish Longitudinal Study on Municipal Employees Study aged 44–58 years at baseline. Outcomes Total mortality from 1981 to 2009 among individuals with complete data on job strain in midlife, categorised according to job demand and job control: high job strain (high job demands and low job control), active job (high job demand and high job control), passive job (low job demand a…
Work-Related Biomechanical Exposure and Job Strain as Separate and Joint Predictors of Musculoskeletal Diseases: A 28-Year Prospective Follow-up Study
We investigated how work-related biomechanical exposure and job strain in midlife separately and jointly predicted back and degenerative musculoskeletal diseases (MSDs). A total of 6,257 employees participated in the Finnish Longitudinal Study on Aging Municipal Employees (FLAME) in 1981 and were followed up for 28 years. Risk ratios and the relative excessive risk due to interaction and 95% confidence intervals were modeled for separate and joint prediction estimates, respectively. After adjustment for confounders, job strain predicted degenerative MSDs among women after 4 and 11 years of follow-up. After 11 years, both exposures predicted both types of MSDs among men. Joint exposure predi…
The need for methods to measure capacity and incapacity from working life to old age
Owing to a sharp increase in population ageing, a decrease in fertility and increase in life expectancy, there is an imbalance between numbers of workers entering and those leaving the workforce. The need to work longer has thus become increasingly important. To promote functional ability during extended work life and after retirement is important to ensure that people of all ages can remain active. Studies on occupational health have traditionally focused on people of working age and gerontology has studied people after retirement. These two research areas have largely remained separate, but this does not have to be the case. Both occupational health research and gerontology require a bala…
Midlife work ability and mobility limitation in old age among non-disability and disability retirees - a prospective study
Little is known about the wellbeing and mobility limitation of older disability retirees. Personal and environmental factors, such as time spent in working life, may either exacerbate or mitigate the onset of mobility limitation in general population. We aimed to study perceived midlife work ability as a determinant of self-reported mobility limitation in old age among municipal employees who transitioned into non-disability and disability retirement. METHODS: 4329 participants of the Finnish Longitudinal Study of Municipal Employees (FLAME) had retired during January 1985 and July 2000. They had data on retirement, perceived work ability in 1985, and self-reported mobility limitation (non-…
Multisite musculoskeletal pain trajectories from midlife to old age : a 28-year follow-up of municipal employees
ObjectivesWe studied the developmental trajectories of multisite musculoskeletal pain (MSP) to learn whether pain in midlife persists to old age, and whether pain trajectories associate with midlife work or lifestyle exposures or retirement from work.MethodsMunicipal employees aged 44–58 years were studied in 1981 (n=6257) with follow-ups in 1985, 1992, 1997 and 2009. Pain in the neck, low back, and upper and lower limbs was assessed in each survey. Trajectories of the number (0–4) of pain sites were defined using growth mixture modelling (n=3093). Workload, lifestyle and morbidity were elicited by questionnaire and retirement from registries. Associations of baseline factors with pain traj…
Inverse Effects of Midlife Occupational and Leisure Time Physical Activity on Mobility Limitation in Old Age-A 28-Year Prospective Follow-Up Study
Objectives: To evaluate in a sample of initially middle-aged municipal employees whether leisure time (LPA) or occupational physical activity (OPA) was associated with mobility limitation (ML) in old age. Design: Prospective population-based follow-up. Setting: Municipalities in Finland. Participants: Public sector employees from the Finnish Longitudinal Study on Municipal Employees (FLAME) initially aged 44 to 58 (N = 5,200). Measurements: Baseline data were collected in 1981, including LPA (average exercise within previous year: inactive (no exercise), moderate (some form of exercise ?1 time per week), vigorous (brisk exercise ?1 time per week)) and OPA (usual activities at work within pr…
Work ability as a determinant of old age disability severity: evidence from the 28-year Finnish Longitudinal Study on Municipal Employees
Background and aims: Lower occupational class correlates with a higher disability risk later in life. However, it is not clear whether the demands made by mental and physical work relative to individual resources in midlife predict well-being in old age. This study investigated prospectively whether work ability in midlife predicts disability severity in activities of everyday living in old age. Methods: Data come from the population-based 28-year follow-up called Finnish Longitudinal Study of Municipal Employees. A total of 2879 occupationally active persons aged 44-58 years answered a questionnaire on work ability at baseline in 1981 and activities of daily living in 2009. At baseline, pe…