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Complex Multimorbidity and Working beyond Retirement Age in Japan: A Prospective Propensity-Matched Analysis

Author

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  • Daisuke Kato

    (Department of Family Medicine, Mie University Graduate School of Medicine, Tsu 514-8507, Japan
    Department of Gerontological Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan)

  • Ichiro Kawachi

    (Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA)

  • Naoki Kondo

    (Department of Social Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto 606-8315, Japan)

Abstract

Background: With the aging of populations worldwide, the extension of people’s working lives has become a crucial policy issue. The aim of this study is to assess the impact of complex multimorbidity (CMM) as a predictor of working status among retirement-aged adults in Japan. Methods: Using a nationwide longitudinal cohort study of people aged over 65 who were free of documented disability at baseline, we matched individuals with respect to their propensity to develop CMM. The primary outcome of the study was working status after the six-year follow-up. Results: Among 5613 older adults (mean age: 74.2 years) included in the study, 726 had CMM and 2211 were still working at the end of the follow-up. In propensity-matched analyses, the employment rate was 6.4% higher in the CMM-free group at the end of the six-year follow-up compared to the CMM group (725 pairs; 29.5% vs. 35.9%; p = 0.012). Logistic regression analysis showed that CMM prevented older people from continuing to work beyond retirement age and was a more important factor than socioeconomic factors (income or educational attainment) or psychological factors (depressive symptoms or purpose in life). Conclusions: Our study found that CMM has an adverse impact on the employment rate of older adults in Japan. This finding suggests that providing appropriate support to CMM patients may extend their working lives.

Suggested Citation

  • Daisuke Kato & Ichiro Kawachi & Naoki Kondo, 2022. "Complex Multimorbidity and Working beyond Retirement Age in Japan: A Prospective Propensity-Matched Analysis," IJERPH, MDPI, vol. 19(11), pages 1-10, May.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:11:p:6553-:d:825869
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    References listed on IDEAS

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    1. Christin-Melanie Vauclair & Sibila Marques & Maria L. Lima & Christopher Bratt & Hannah J. Swift & Dominic Abrams, 2015. "Subjective Social Status of Older People Across Countries: The Role of Modernization and Employment," The Journals of Gerontology: Series B, The Gerontological Society of America, vol. 70(4), pages 650-660.
    2. Honaker, James & King, Gary & Blackwell, Matthew, 2011. "Amelia II: A Program for Missing Data," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 45(i07).
    3. Peter C. Austin, 2009. "The Relative Ability of Different Propensity Score Methods to Balance Measured Covariates Between Treated and Untreated Subjects in Observational Studies," Medical Decision Making, , vol. 29(6), pages 661-677, November.
    4. Daisuke Kato & Ichiro Kawachi & Junko Saito & Naoki Kondo, 2021. "Complex Multimorbidity and Incidence of Long-Term Care Needs in Japan: A Prospective Cohort Study," IJERPH, MDPI, vol. 18(19), pages 1-11, October.
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    1. Marie Bjuhr & Maria Engström & Anna-Karin Welmer & Magnus Lindberg & Britt-Marie Sjölund, 2022. "Incentives behind and Experiences of Being Active in Working Life after Age 65 in Sweden," IJERPH, MDPI, vol. 19(23), pages 1-10, November.
    2. John Rodwell & Thomas Hendry & Dianne Johnson, 2022. "A Parsimonious Taxonomy of The Newly Retired: Spousal and Disability Combinations Shape Part or Complete Retirement," IJERPH, MDPI, vol. 19(20), pages 1-13, October.

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