Trajectories of low back pain from midlife to retirement and functional ability at old age

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Trajectories of low back pain from midlife to retirement and functional ability at old age

BackgroundThis study aimed to identify trajectories of low back pain (LBP) over a 16-year follow-up from midlife to retirement and investigate their association with mobility limitations and disability in activities of daily living (ADL-disability) in later life.MethodsThe study population consisted of 6257 baseline (1981) respondents aged 44–58 years from Finnish Longitudinal study on Aging Municipal Employees. Repeated measurements of LBP were collected in 1985, 1992 and 1997. We studied persons who had data on LBP at baseline and in at least one of the follow-ups and had information on mobility limitations (n = 2305) and ADL-disability (n = 2359) at a 28-year follow-up in 2009. Latent class growth analysis was used to identify LBP trajectories. Odds ratios (ORs) with 95% confidence intervals (CIs) for the associations of LBP trajectory and later life mobility limitations and ADL-disability were estimated and adjusted for confounders.ResultsThree LBP trajectories with parallel shapes were identified: high-decreasing (19%), intermediate-stable (60%) and low (21%). After adjustment for confounders, high-decreasing trajectory had 3.2 times the odds (95% CI 2.1–4.9) of mobility limitations and 2.9 times the odds (95% CI 2.0–4.2) of ADL-disability as compared to low trajectory. The respective ORs for intermediate-stable trajectory were 1.6 (95% CI 1.2–2.1) and 1.7 (95% CI 1.3–2.3).ConclusionsAmong majority of respondents, LBP remained stable over the follow-up. The respondents belonging to intermediate-stable and high-decreasing trajectories of LBP had higher odds of mobility limitations and ADL-disability at old age. This highlights that LBP during midlife to retirement has far-reached consequences on functional ability at old age.</p

Perceived Work Ability during Enforced Working from Home Due to the COVID-19 Pandemic among Finnish Higher Educational Staff

Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees’ work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher education employees in a one-year follow-up during the enforced WFH. Secondly, we investigated demographic, organizational, and ergonomic factors associated with the developmental profiles. Methods: A longitudinal web-survey was conducted with four measurement points (April 2020–February 2021). Employees of a Finnish university who answered the questionnaire at baseline and at least at two follow-up surveys (n = 678) were included (71% women, 45% teachers/research staff, 44% supporting staff, 11% hired students). Perceived work ability was measured on a scale of 1–5 in all timepoints. Latent class growth curve analysis was used to identify profiles of work ability. Multinomial logistic regression was used to determine the associations of demographic factors, perceived stress, musculoskeletal pain, functionality of home for work, and organizational support with the work ability profiles. Results: Six distinct work ability profiles were identified. For most (75%), work ability remained stable during the follow-up. A total of 17% had a favourable trend (very good-stable or increasing) of work ability, and 8% had non-favourable (poor-stable or decreasing). Poor ergonomics at home, low organizational support, high stress, and musculoskeletal pain were associated with non-favourable development of work ability. Conclusions: Heterogeneity in development of work ability during forced WFH was found. Several factors were identified through which work ability can be supported.publishedVersionPeer reviewe

Educational Differences in Decline in Maximum Gait Speed in Older Adults over an 11-year Follow-up

Background: This study examined educational differences in decline in maximum gait speed over an 11-year follow-up in the general Finnish population aged ≥55 years, and assessed the contribution of lifestyle factors, body mass index, physical workload and chronic conditions on the association.Methods: Data from the nationally representative Health 2000 Survey and it's 11-year follow-up was used. Participants aged 55 years and older with maximum gait speed measured at both time-points were included (n=1128). Information on education, age, sex, lifestyle factors, body mass index, physical workload and chronic conditions was collected at baseline. General linear model was used to examine differences in decline in maximum gait speed between education groups. Mediation analyses using the product method was conducted to partition the total effect of education on decline in maximum gait speed into direct effect and indirect effect acting through mediators.Results: Decline in maximum gait speed was greater in low and intermediate education groups in comparison to the high education group [0.24 m/s, 95% confidence interval (0.21, 0.26), 0.24 m/s (0.21, 0.28), 0.10 m/s (0.07, 0.14), respectively]. The most important mediators were higher body mass index and lifetime exposure to physical workload among the less educated, accounting for 10% and 11% of the total effect, respectively.Conclusions: Education-based disparities in objectively measured mobility increase with age as lower education is associated with greater decline in gait speed. Higher body mass index and physical workload among less educated contributed most to the educational disparities in age-related decline in maximum gait speed.</p

Effectiveness of interventions on the stress management of schoolteachers : a systematic review and meta-analysis

BACKGROUND: This systematic review aimed to analyse the effectiveness of interventions on the stress management of schoolteachers. METHODS: We searched the Medline, PsycINFO, CINAHL and Education Research Complete until 30 November 2021, to identify relevant studies using relevant key words. Job or occupational stress was used as the outcome measure. Stress was defined as Perceived Stress Scale, Teacher Stress Inventory, Maslach Burnout Inventory, Teacher's Distress, Brief Symptoms Inventory or Global Severity Index. Study selection, data extraction, risk of bias assessment was performed by two independent reviewers. The pooled estimate of the effect by the type of outcome measurement tool and by type of interventions used was calculated using random effects meta-analysis. We used Grades of Recommendations, Assessment, Development and Evaluation to assess the overall quality of the evidence. RESULTS: We reviewed 26 studies, of which 24 were randomised trials and 2 pre-test/post-test studies. Based on meta-analysis, a positive effect of intervention (pooled estimate -1.13, 95% CI -1.52 to -0.73) with high heterogeneity among studies (χ 2=426.88, p<0.001, I 2=94%) was found by type of interventions used. Cognitive-behavioural therapy had the strongest positive effect, followed by meditation among the types of interventions studied. We identified evidence of a moderate quality for interventions aiming to manage the stress level of schoolteachers. CONCLUSIONS: The meta-analysis showed a positive effect of interventions, suggesting that interventions might reduce the stress level among teachers. The quality of the evidence was moderate. PROSPERO REGISTRATION NUMBER: CRD42021225098.Peer reviewe

Can workplace intervention prolong work life of older workers? : A quasi-experimental study

BACKGROUND: We aimed to evaluate the impact of a workplace senior program intervention on early exit from labor market and on the disability retirement among older employees and work-related physical factors associated with it. METHODS: A total of 259 individuals aged 55 + years participated in the study (107 in intervention and 152 were controls). A questionnaire survey was conducted among Finnish food industry employees between 2003 and 2009 and the intervention "senior program" was provided between 2004 and 2009. The type of pension for the respondents who had retired by 2019 was obtained and dichotomized as statutory vs. early labor market exit. Disability pension was investigated as a separate outcome. Information on work-related factors was obtained from the survey. Cox regression analysis was used to estimate hazard ratios (HR) with their 95% confidence intervals. RESULTS: Fifty-one employees had early labor market exit. Of them, 70% (n = 36) were control participants. Employees in the senior program worked for longer years (mean years 7.4, 95% CI 6.4-8.1) compared to the control (6.6, 95% CI 6.3-7.5). Sixty percent lower risk of early labor market exit (HR 0.40, 95% CI 0.19-0.84) and disability pension was found among employees in the senior program compared to the control group. Good work ability had a 94% lower risk (0.06, 95% CI 0.01-0.29) of early labor market exit and 85% lower risk (0.15, 95% CI 0.03-0.73) of disability pension compared to poor work ability. Employees with musculoskeletal pain had 4 times higher risk of disability pension compared to those without musculoskeletal pain. CONCLUSIONS: A workplace senior program intervention prolonged work life and had positive effect on reducing disability pension among older industrial workers.publishedVersionPeer reviewe

Quality of work community and workers' intention to retire

PURPOSE: To study the workers' perception of the quality of work community and its association with intention to retire early, separately among women and men working in Finnish postal service. METHODS: A questionnaire survey was sent to all Finnish postal services employees aged ≥ 50 years in 2016 and 44% (n = 2096) replied to the survey (mean age 56.3, 40% women). Employee's intention to retire before statutory retirement was measured on a scale of 1-5 and dichotomized. The quality of work community was defined by four composite variables: equality at work, flexibility at work, supportive work environment and health or other reason and trichotomized by their tercile values. Odds ratio (ORs) and their 95% confidence intervals (CIs) for associations of quality of work community with intention to retire were calculated separately for men and women using log binomial regression models adjusted for potential confounders. RESULTS: About one-third of respondents intended to retire early with no significant gender difference in retirement intention. Low equality at work (women OR 2.77, 95% CI 1.60-4.81; men 2.84, 1.80-4.48) and low flexibility at work (women 3.30, 1.94-5.60; men 2.91, 1.88-4.50) was associated with higher likelihood of intention to retire. Among women intention to retire was found less likely due to low supportive work environment (0.52, 0.31-0.89) and among men due to intermediate health or other reason (0.65, 043-0.98). CONCLUSION: The results highlight the importance of the quality of work community as well as the promotion of work-related health in order to encourage employees to remain at workforce for longer.publishedVersionPeer reviewe

Indicators of Sustainable Employability among Older Finnish Postal Service Employees: A Longitudinal Study of Age and Time Effects

We first clarify the definition of sustainable employability, and then we study how the indicators of sustainable employability among older Finnish postal service employees have changed over time. Finally, we estimate the effect of age on these indicators in a two-year follow up. A questionnaire survey among the Finnish postal service employees was conducted in 2016, and a follow-up was conducted in 2018. We analyze data from 1262 subjects who replied to both the baseline and the follow-up surveys. Sustainable employability is defined as a multidimensional construct using nine indicators and covering three domains (health, well-being and employability) based on Fleuren and colleagues' model. Measurement time (repeated measure) is used as a within-subjects factor, and age is used as a between-subjects factor. The estimated marginal means of the indicators of sustainable employability at the baseline and the follow-up by age in years are calculated. No significant change is found in eight indicators (work ability, time and resources, recovery after work, job satisfaction, motivation, perceived employment, enough training on the job and relevance of work) of sustainable employability after the two-year follow-up. We find a statistically significant effect of time on self-rated health (F = 6.56, p = 0.011). Six out of nine indicators (self-rated health, work ability, time and resources, recovery after work, job satisfaction, and perceived employment) have a statistically significant effect of age between subjects. Partial Eta Squared  (ŋ2p) shows a very small difference in the indicators of sustainable employability during the follow-up, indicating that the employability of the workers was sustained throughout. We used the Fleuren model as the basis for our definition of sustainable employability. Although they are based on single items, these indicators of sustainable employability remain stable after the two-year follow-up. Significant effects of age between subjects are found for six out of nine indicators. The results suggest that age may be an important determinant of sustainable employability.</p

Development and validation of sustainable employability index among older employees

BACKGROUND: Sustainable employability (SE) has become an important factor for keeping people in the labour market and enabling the extension of working life. AIMS: We developed and validated an SE index to predict assured workability in 2 years. Additionally, we developed a scoring tool to use in practice. METHODS: A questionnaire survey of postal employees aged ≥50 years was conducted in 2016 and followed up in 2018 (n = 1102). The data were divided into training and validation sets. The outcome was defined as whether the employees had an assured workability after 2 years or not. Multivariable log-binomial regression was used to calculate the SE index. The area under the curve (AUC) was calculated to assess the discriminative power of the index. RESULTS: The probability of assured workability increased with increasing quintiles of the SE index. The highest quintiles of the SE index showed the highest observed and expected assured workability in 2 years. The predictive ability, area under the curve (AUC) for training was 0.79 (95% CI 0.75-0.83) and for validation data was 0.76 (95% CI 0.73-0.80). In the scoring tool, the self-rated health, workability, job satisfaction and perceived employment had the highest contribution to the index. CONCLUSIONS: The SE index was able to distinguish the employees based on whether they had assured workability after 2 years. The scoring method could be used to calculate the potentiality of future employability among late midlife postal employees.publishedVersionPeer reviewe

Quality of work community and workers' intention to retire

Purpose: To study the workers' perception of the quality of work community and its association with intention to retire early, separately among women and men working in Finnish postal service.Methods: A questionnaire survey was sent to all Finnish postal services employees aged >= 50 years in 2016 and 44% (n = 2096) replied to the survey (mean age 56.3, 40% women). Employee's intention to retire before statutory retirement was measured on a scale of 1-5 and dichotomized. The quality of work community was defined by four composite variables: equality at work, flexibility at work, supportive work environment and health or other reason and trichotomized by their tercile values. Odds ratio (ORs) and their 95% confidence intervals (CIs) for associations of quality of work community with intention to retire were calculated separately for men and women using log binomial regression models adjusted for potential confounders.​​​​​​​Results: About one-third of respondents intended to retire early with no significant gender difference in retirement intention. Low equality at work (women OR 2.77, 95% CI 1.60-4.81; men 2.84, 1.80-4.48) and low flexibility at work (women 3.30, 1.94-5.60; men 2.91, 1.88-4.50) was associated with higher likelihood of intention to retire. Among women intention to retire was found less likely due to low supportive work environment (0.52, 0.31-0.89) and among men due to intermediate health or other reason (0.65, 043-0.98). Conclusion: The results highlight the importance of the quality of work community as well as the promotion of work-related health in order to encourage employees to remain at workforce for longer.</p