{"title":"日本社区老年人就业状况和残疾发病的差异:一项前瞻性队列研究。","authors":"Kazuya Fujii, Sangyoon Lee, Osamu Katayama, Keitaro Makino, Kenji Harada, Kouki Tomida, Masanori Morikawa, Ryo Yamaguchi, Chiharu Nishijima, Yuka Misu, Hiroyuki Shimada","doi":"10.1007/s00420-023-02000-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>This prospective cohort study investigates the relationship between the onset of disability and employment status.</p><p><strong>Methods: </strong>We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status.</p><p><strong>Results: </strong>The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status.</p><p><strong>Conclusions: </strong>Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.</p>","PeriodicalId":13761,"journal":{"name":"International Archives of Occupational and Environmental Health","volume":null,"pages":null},"PeriodicalIF":2.6000,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study.\",\"authors\":\"Kazuya Fujii, Sangyoon Lee, Osamu Katayama, Keitaro Makino, Kenji Harada, Kouki Tomida, Masanori Morikawa, Ryo Yamaguchi, Chiharu Nishijima, Yuka Misu, Hiroyuki Shimada\",\"doi\":\"10.1007/s00420-023-02000-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>This prospective cohort study investigates the relationship between the onset of disability and employment status.</p><p><strong>Methods: </strong>We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status.</p><p><strong>Results: </strong>The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status.</p><p><strong>Conclusions: </strong>Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.</p>\",\"PeriodicalId\":13761,\"journal\":{\"name\":\"International Archives of Occupational and Environmental Health\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.6000,\"publicationDate\":\"2023-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Archives of Occupational and Environmental Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00420-023-02000-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/7/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Archives of Occupational and Environmental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00420-023-02000-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/7/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
Difference in employment status and onset of disability among Japanese community-dwelling older adults: a prospective cohort study.
Objective: This prospective cohort study investigates the relationship between the onset of disability and employment status.
Methods: We investigated 3,741 community-dwelling adults aged 70 or older, who participated in a population-based cohort study in Japan. Their onset of disability was monitored monthly using the long-term care insurance certification registration system, for five years from baseline. Based on an employment status questionnaire, we categorized participants into three groups: (1) employee, (2) self-employed, and (3) not working. Covariates included demographic information, medical history, number of medications, educational level, living alone, social group engagement, smoking status, walking speed, instrumental activities of daily living, global cognitive function, and depressive symptoms. Missing values were managed using multiple imputation. Cox proportional hazard models were used to calculate hazard ratios (HRs) with 95% confidence intervals (CIs) for incident disability risk by employment status.
Results: The disability incidence rates were 15.3/1,000 (95% CIs: 10.7-22.0) person-years among employees, and 33.0/1000 (95% CIs: 24.4-44.6) and 39.6/1000 (95% CIs: 36.5-43.0) person-years among self-employed and non-working participants, respectively. The adjusted HRs for the onset of disability among non-working and self-employed participants were 1.69 (95% CIs: 1.16-2.46, p = 0.007) and 1.63 (95% CIs: 1.01-2.62, p = 0.044) compared with employees, respectively. Similar results were found among men. Among women, disability onset was not associated with employment status.
Conclusions: Older adults' risk of disability onset differed according to their employment status. Older employees had a lower risk of disability onset than those not working or self-employed.
期刊介绍:
International Archives of Occupational and Environmental Health publishes Editorials, Review Articles, Original Articles, and Letters to the Editor. It welcomes any manuscripts dealing with occupational or ambient environmental problems, with a special interest in research at the interface of occupational health and clinical medicine. The scope ranges from Biological Monitoring to Dermatology, from Fibers and Dust to Human Toxicology, from Nanomaterials and Ultra-fine Dust to Night- and Shift Work, from Psycho-mental Distress and Burnout to Vibrations. A complete list of topics can be found on the right-hand side under For authors and editors.
In addition, all papers should be based on present-day standards and relate to:
-Clinical and epidemiological studies on morbidity and mortality
-Clinical epidemiological studies on the parameters relevant to the estimation of health risks
-Human experimental studies on environmental health effects. Animal experiments are only acceptable if relevant to pathogenic aspects.
-Methods for studying the topics mentioned above.