Life course and work ability among older adults: ELSI-Brazil

Castro, Camila Menezes Sabino de; Lima-Costa, Maria Fernanda; César, Cibele Comini; Neves, Jorge Alexandre Barbosa; Andrade, Fabíola Bof de; Souza Junior, Paulo Roberto Borges de; Sampaio, Rosana Ferreira

doi:10.11606/S1518-8787.2018052000648

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Brasil

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Sumário

Supplement ELSI-Brazil, Original Article • Rev. Saúde Pública 52 (Suppl 2) • 2018 • https://doi.org/10.11606/S1518-8787.2018052000648 copy

Life course and work ability among older adults: ELSI-Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

OBJECTIVE

To examine factors associated with perception of work ability in a nationally representative sample of Brazilians aged 50 years and over.

METHODS

We used data from 8,903 participants of the baseline survey of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The dependent variable was self-rated work ability (good or very good versus fair, poor, or very poor). Independent variables included factors that operate at the beginning, middle, and current stage of life. Multivariate analysis was based on prevalence ratios (PR) and 95% confidence intervals (95%CI) estimated by Poisson regression.

RESULTS

Good work ability was reported by 49% of \ participants (49.4% among men and 48.6% among women). Results of the multivariate analysis showed that, for both men and women, good work ability showed positive and statistically significant associations (p < 0.05) with good health up to 15 years of age (PR = 1.22 and 1.18 , respectively), educational level ≥ 8 years (PR = 1.19 and 1.21, respectively), and current good self-rated health (PR = 1.88 and 1.94, respectively). Negative associations were observed for current age (PR = 0.99 for each increase of one year among men and women), medical diagnosis of depression (PR = 0.70 for men and PR = 0.87 for women), and having one or more at least chronic diseases (PR = 0.88 for men and 0.91 for women). Only for men, positive associations for the age at which they started working (PR = 1.14 and 1.12 for 11–17 and ≥ 18 years, respectively) and living with a spouse (PR = 1.09) were found.

CONCLUSIONS

Work ability in older ages is built over the life course, particularly by the health conditions in childhood and adolescence, age at which men begin working, educational level, and health conditions in older ages. Policies aimed at increasing longevity in the labor market must take these factors into account.

Aged; Work Capacity Evaluation; Health; Chronic Disease; Socioeconomic Factors; Epidemiologic Factors; Health Surveys

Variable	Total (n = 8,903)		Men (n = 3,942)		Women (n = 4,961)		p^b

	%^a	95%CI	%^a	95%CI	%^a	95%CI
Good current work ability	49.0	46.6–51.4	49.4	46.4–52.5	48.6	46.2–51.0	0.511

Early life conditions

Attended school at the age of 10	75.5	72.3–78.5	75.5	71.6–78.9	75.6	72.4–78.5	0.941
Financial situation of the family up to 15 years of age
Above or within the average	27.7	25.4–30.0	26.8	24.3–29.4	28.4	25.9–31.1	< 0.001
Poor	57.3	54.9–59.6	56.0	53.2–58.8	58.4	55.7–61.1
Variable	15.0	13.9–16.3	17.2	15.6–18.9	13.2	12.0–14.4
Good health up to 15 years of age	78.0	76.2–79.6	78.8	76.8–80.7	77.2	75.2–79.1	0.138
Age at which started working (years)
< 10	42.2	39.8–44.7	45.3	42.4–48.3	39.5	37.0–42.0	< 0.001
11–17	40.6	38.4–42.8	42.7	40.0–45.5	38.7	36.3–41.2
≥ 18	17.2	15.2–19.5	12.0	10.4–13.8	21.8	19.2–24.6

Conditions in the intermediate stages of life

Physical demands of the previous work
Never worked/Sitting	17.7	16.1–19.3	16.7	14.9–18.7	18.5	16.6–20.5	< 0.001
Some physical effort	63.4	60.8–66.0	55.9	52.6–59.2	70.1	67.2–72.8
Intense physical effort	18.9	16.7–21.3	27.6	24.2–30.8	11.4	9.3–13.9
Education level (full years)
< 8	63.5	60.5–66.3	62.4	58.8–65.8	64.4	61.4–67.3	0.173

Current life conditions

Age, mean (SD)	63.7 (9.9)	63.5–63.9	62.9 (9.8)	62.6–63.2	64.3 (10.0)	64.0–64.6	< 0.001
Responsible for the household	73.5	71.7–75.3	87.0	84.7–89.0	61.7	57.8–65.4	< 0.001
Living with spouse or partner	64.3	61.4–67.1	75.6	72.9–78.1	54.3	51.2–57.3	< 0.001
Good self-rated health	44.0	41.5–46.5	43.7	40.4–47.0	44.3	41.7–46.8	0.701
Medical diagnosis of depression	18.6	16.8–20.5	10.6	9.2–12.2	25.6	23.1–28.3	< 0.001
One or more chronic diseases^c	82.7	81.5–83.9	76.7	75.0–78.3	88.1	86.7–89.4	< 0.001

Variable	Good current work ability

	Men (n = 3,942)		Women (n = 4,961)

	%^a	PR (95%CI)^b	%^a	PR (95%CI)^b
Early life conditions

Attended school at the age of 10
No	39.1	1	38.5	1
Yes	52.8	1.04 (0.94–1.15)	51.8	1.06 (0.96–1.16)
Financial situation of the family up to 15 years of age
Above/Within average	56.3	1	55.1	1
Poor	44.8	0.95 (0.88–1.02)	44.3	0.94 (0.87–1.02)
Variable	53.8	1.02 (0.93–1.12)	53.3	1.02 (0.94–1.11)
Good health up to 15 years of age
No	36.0	1	37.8	1
Yes	53.1	1.22 (1.08–1.36)	51.8	1.18 (1.08–1.30)
Age at which started working
≤ 10	41.7	1	42.8	1
11–17	55.4	1.14 (1.05–1.23)	48.8	1.00 (0.93–1.08)
≥ 18	57.5	1.12 (1.01–1.24)	58.7	1.07 (0.96–1.18)

Conditions in the middle stages of life

Physical demands of the previous work
Never worked/Sitting	58.1	1	54.4	1
Some physical effort	52.1	0.99 (0.92–1.07)	49.2	1.02 (0.94–1.10)
Intense physical effort	38.6	0.90 (0.81–1.01)	35.6	0.87 (0.73–1.04)
Education level (full years)
0–7	40.6	1	41.2	1
≥ 8	64.0	1.19 (1.10–1.28)	61.9	1.21 (1.10–1.33)

Current life conditions

Age (continuous)	61.0	0.99 (0.98–0.99)	61.7	0.99 (0.98–0.99)
Responsibility for the household
No	46.9	1	50.2	1
Yes	49.8	1.09 (0.95–1.25)	47.6	0.97 (0.88–1.06)
Living with spouse or partner
No	46.4	1	45.8	1
Yes	50.4	1.09 (1.02–1.17)	50.9	1.05 (0.96–1.15)
Self-rated health
Poor	32.5	1	32.2	1
Good	71.3	1.88 (1.72–2.05)	69.2	1.94 (1.80–2.09)
Medical diagnosis of depression
No	51.9	1	51.9	1
Yes	28.6	0.70 (0.58–0.84)	38.8	0.87 (0.80–0.95)
One or more chronic diseases^c
0	64.2	1	66.2	1
≥ 1	44.9	0.88 (0.82–0.94)	46.2	0.91 (0.85–0.97)

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[1] Correspondence: Maria Fernanda Lima-Costa. Av. Augusto de Lima, 1715 Barro Preto. 30190-002 Belo Horizonte, MG, Brasil. E-mail: lima-costa@cpqrr.fiocruz.br