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. 2010 Nov 23:341:c6149.
doi: 10.1136/bmj.c6149.

Effect of retirement on major chronic conditions and fatigue: French GAZEL occupational cohort study

Hugo Westerlund  1 , Jussi Vahtera, Jane E Ferrie, Archana Singh-Manoux, Jaana Pentti, Maria Melchior, Constanze Leineweber, Markus Jokela, Johannes Siegrist, Marcel Goldberg, Marie Zins, Mika Kivimäki
Affiliations

Effect of retirement on major chronic conditions and fatigue: French GAZEL occupational cohort study

Hugo Westerlund et al. BMJ. .

Abstract

Objectives: To determine, using longitudinal analyses, if retirement is followed by a change in the risk of incident chronic diseases, depressive symptoms, and fatigue. Design Prospective study with repeat measures from 7 years before to 7 years after retirement.

Setting: Large French occupational cohort (the GAZEL study), 1989-2007. Participants 11 246 men and 2858 women.

Main outcome measures: Respiratory disease, diabetes, coronary heart disease and stroke, mental fatigue, and physical fatigue, measured annually by self report over the 15 year observation period; depressive symptoms measured at four time points.

Results: The average number of repeat measurements per participant was 12.1. Repeated measures logistic regression with generalised estimating equations showed that the cumulative prevalence of self reported respiratory disease, diabetes, and coronary heart disease and stroke increased with age, with no break in the trend around retirement. In contrast, retirement was associated with a substantial decrease in the prevalence of both mental fatigue (odds ratio for fatigue one year after versus one year before retirement 0.19, 95% confidence interval 0.18 to 0.21) and physical fatigue (0.27, 0.26 to 0.30). A major decrease was also observed in depressive symptoms (0.60, 0.53 to 0.67). The decrease in fatigue around retirement was more pronounced among people with a chronic disease before retirement.

Conclusions: Longitudinal modelling of repeat data showed that retirement did not change the risk of major chronic diseases but was associated with a substantial reduction in mental and physical fatigue and depressive symptoms, particularly among people with chronic diseases.

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Conflict of interest statement

Competing interests: All authors have completed the Unified Competing Interest form at www.icmje.org/coi_disclosure.pdf (available on request from the corresponding author) and declare that (1) regarding the submitted work HW and CL have support from the Swedish Council for Working Life and Social Research (FAS); JV and MK have support from the Academy of Finland; MK has additional support from the BUPA Foundation, UK; MK and AS-M also have support from the National Institutes of Health (NIH), USA; AS-M has additional support from the European Science Foundation (ESF); JF and all other authors except JS have additional support from ESRC, UK; MG and MZ have additional support from the Institut de recherche en santé publique (INSERM) and Caisse centrale d’action sociale, France; and JS had support from Agence nationale de la recherché (ANR), France; (2) none of the authors have any relationships with any company or organisation that might have an interest in the submitted work in the previous 3 years; (3) their spouses, partners, or children have no financial relationships that may be relevant to the submitted work; and (4) the authors have no non-financial interests that may be relevant to the submitted work.”

Figures

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Fig 1 Flow chart describing selection of participants in study
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Fig 2 Trajectories of health in relation to retirement. Top panel shows prevalence of chronic diseases; bottom panel shows prevalence trajectories for mental and physical fatigue and depressive symptoms by year (year 0 is year of retirement). Trajectories are adjusted for time period. Wider confidence intervals for depression are result of only four measurement points as opposed to 15 for other variables; prevalences could be estimated for all years as retirement could occur in any year
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Fig 3 Comparison of distribution of responses to questions about mental and physical fatigue in year before and year after retirement
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