Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60-64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden.

The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60-64 were associated with being in paid work when aged 66-71. This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60-64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005-2009) and paid work as the outcome variable (2011-2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex. Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69-0.84; men 0.74; 0.65-0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84-0.91; men 0.92; 0.89-0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65-0.91), but not women (0.98; 0.88-1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34-0.45; women somatic DP 0.38; 0.35-0.41; women mental and somatic DP 0.28; 0.15-0.56; men mental DP 0.36; 0.29-0.43; men somatic DP 0.35; 0.32-0.38; men mental and somatic DP 0.22; 0.10-0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57-0.65). SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.

Martikainen A ，Svensson Alavi A ，Alexanderson K ，Farrants K ... -  《BMC PUBLIC HEALTH》

Sickness Absence and Disability Pension in the Trade and Retail Industry: A Prospective Cohort Study of 192,000 White-Collar Workers in Sweden.

This study aimed to investigate future sickness absence (SA) and disability pension (DP) among privately employed white-collar employees in the trade and retail industry. A prospective population-based cohort study of all 192,077 such workers in Sweden in 2012, using linked microdata from nationwide registers, was conducted. Descriptive statistics of annual SA/DP during 2010 to 2016 and logistic regression for SA/DP in 2016 were used. Women had more mean SA/DP net days/person; however, there were no sex differences in the mean number of net days/person with SA/DP. The mean number of net days/person increased, especially with mental diagnoses. Sickness absence in 2012 was the strongest factor associated with SA/DP in 2016 (women: odds ratio, 3.28; 95% confidence interval, 3.09-3.47; men: odds ratio, 4.10; 95% confidence interval, 3.76-4.48). Work-related factors were weakly associated with future SA/DP. The number of SA/DP net days per person increased, especially SA/DP days due to mental diagnoses.

Farrants K ，Alexanderson K 《-》

Working life sequences over the life course among 9269 women and men in Sweden; a prospective cohort study.

To investigate working life courses in women and men and possible associations with socioeconomic, health-, and work-related factors. A 15-year prospective cohort study of individuals aged 18-50 in paid work at baseline and answering the Swedish Living Conditions Surveys (2000-2003, N = 9269) and their annual economic activity, using nationwide registers. We used sequence and cluster analyses to identify and group similar working life sequences. Multinomial logistic regression was used to examine associations of sex, socioeconomic, health-, and work-related factors with sequence cluster memberships. We identified 1284 working life sequences, of which 65% represented continuous active (in paid work/studying) states. We then identified five sequence clusters, the largest one with individuals who were continuously active (n = 6034, 65% of the participants; 54% of women and 76% of men) and smaller ones with interruptions of the active state by long-term parental-leave, unemployment, and/or sickness absence/disability pension (SA/DP), or retirement. Women were more likely than men to belong to the "Parental-leave periods" (odds ratio [OR]: 33.2; 95% confidence intervals [CI]: 25.6, 43.1) and the "SA/DP periods" sequence clusters (OR: 1.8; 95% CI: 1.4, 2.1), also after adjustment for covariates. In both sexes, low education and poor health were the strongest predictors of belonging to the sequence cluster "Unemployment & SA/DP periods". Predictors of the "Parental-leave periods" sequence cluster differed between women and men. In a cohort of individuals in paid work at baseline, the majority of women and men worked most of each year although women were more likely to have some interruptions characterized by long-term parental-leave or SA/DP periods than men, independently of socioeconomic, health-, and work-related factors.

Gémes K ，Heikkilä K ，Alexanderson K ，Farrants K ，Mittendorfer-Rutz E ，Virtanen M ... -  《-》

Diagnosis-specific sickness absence and disability pension before and after multiple sclerosis diagnosis: An 8-year nationwide longitudinal cohort study with matched references.

Multiple sclerosis (MS) typically onsets when of working age and may reduce work capacity. Previous studies have examined the risk of sickness absence (SA) and disability pension (DP) among MS patients, however, limited knowledge is available on whether MS patients have an excess risk for SA/DP when compared with the general population in Sweden. Moreover, no information exists on the actual diagnoses for SA and DP among MS patients and whether the patterns of SA/DP diagnoses differs to those without MS. We aimed to explore diagnosis-specific SA and DP among working-aged MS patients both before and after MS diagnosis, in comparison to the levels and distributions of SA and DP diagnoses of a matched reference group and analyze the risk of diagnosis-specific DP. Longitudinal Swedish register data of the 2567 MS patients diagnosed with MS in 2009-2012 when aged 25-59 and 10,268 population-based matched references (matched on sex, age, educational level, type of living area, and country of birth) were analysed regarding annual diagnosis-specific SA and DP in the four years before and four years after MS diagnosis. Annual differences in the mean numbers of SA and/or DP net days were calculated with 95% confidence intervals (CI). Hazard ratios (HR) with 95% CI from Cox proportional hazard models were used to compare risks for new all-cause and diagnosis-specific DP after MS diagnosis among the MS patients and references. The mean SA/DP net days/year increased among MS patients over follow-up, due to both MS and other diagnoses. During follow-up, around 50% of MS patients had some SA/DP compared to 20% of references. The mean days of SA/DP among the MS patients compared to references increased from 10.3 more days (95% CI: 6.6-14.2) four years prior to MS diagnosis to 68.9 days (62.8-75.1) 4 years after MS diagnosis. Although most new DP among MS patients were due to MS, 15% were not. The adjusted HR for all-cause DP was 23.1 (18.1-29.5). MS patients also had higher risks of new DP due to all diagnoses except MS (HR 3.4; 2.4-4.8), musculoskeletal (HR 2.6; 1.1-6.0) and mental (HR 2.0; 1.1-3.6) diagnoses compared with references. MS patients had higher levels of SA/DP days/year than the references, already 4 years before the MS diagnosis, and increasingly so thereafter. The excess of SA/DP prior to MS diagnosis could be related to MS onset. However, the excess of SA/DP days were not all due to MS diagnoses, even after being diagnosed with MS. MS patients had a higher risk of having a new DP after being diagnosed with MS in total, but also for diagnoses other than MS.

Murley C ，Karampampa K ，Alexanderson K ，Hillert J ，Friberg E ... -  《-》

Sequence analysis of sickness absence and disability pension days in 2012-2018 among privately employed white-collar workers in Sweden: a prospective cohort study.

Salonen L ，Alexanderson K ，Farrants K 《BMJ Open》