%0 Journal Article %J Scientific Reports %D 2020 %T Behavioural risk factors and healthy life expectancy: evidence from two longitudinal studies of ageing in England and the US %A Zaninotto, Paola %A Head, Jenny %A Andrew Steptoe %K Diseases %K Risk Factors %X We examined whether the co-occurrence of four behavioural risk factors (alcohol consumption, smoking, physical inactivity and obesity) is associated with disability-free and chronic disease-free life expectancy similarly in two longitudinal studies of ageing in England and the United States. Data were from 17,351 individuals aged 50+ from the US Health and Retirement Study (HRS) and, 10,388 from the English Longitudinal Study of Ageing (ELSA), from 2002 to 2013. Disability-free life expectancy was estimated using repeat measures of limitations with instrumental activities and activities of daily living and, chronic disease-free life expectancy was based on chronic health conditions. Multistate life table models were used to estimate sex-specific health expectancy at the ages of 50, 60 and 70. In both countries and at all ages, there was a clear gradient towards shorter health expectancy with increasing number of behavioural risk factors. Compared to people with 2+ behavioural risk factors, in both countries, those with no behavioural risk factors could expect to live up to 11 years longer without disability and, up to 12 years longer without chronic conditions. Individual and co-occurring behavioural risk factors were strongly associated with shorter healthy life expectancy in both countries, attesting to the robustness of the contribution of lifestyle factors on health expectancy. %B Scientific Reports %V 10 %@ 2045-2322 %G eng %9 Journal %! Scientific Reports %R 10.1038/s41598-020-63843-6 %0 Journal Article %J International Journal of Obesity %D 2020 %T Long working hours and change in body weight: analysis of individual-participant data from 19 cohort studies %A Virtanen, Marianna %A Markus Jokela %A Lallukka, Tea %A Magnusson Hanson, Linda %A Pentti, Jaana %A Solja T. Nyberg %A Alfredsson, Lars %A G David Batty %A Casini, Annalisa %A Clays, Els %A DeBacquer, Dirk %A Ervasti, Jenni %A Fransson, Eleonor %A Halonen, Jaana I. %A Head, Jenny %A Kittel, France %A Knutsson, Anders %A Leineweber, Constanze %A Nordin, Maria %A Oksanen, Tuula %A Pietiläinen, Olli %A Rahkonen, Ossi %A Salo, Paula %A Archana Singh-Manoux %A Stenholm, Sari %A Suominen, Sakari B. %A Theorell, Töres %A Vahtera, Jussi %A Westerholm, Peter %A Westerlund, Hugo %A Mika Kivimäki %K Preventive medicine %K Risk Factors %X Objective To examine the relation between long working hours and change in body mass index (BMI). Methods We performed random effects meta-analyses using individual-participant data from 19 cohort studies from Europe, US and Australia (n = 122,078), with a mean of 4.4-year follow-up. Working hours were measured at baseline and categorised as part time (<35 h/week), standard weekly hours (35–40 h, reference), 41–48 h, 49–54 h and ≥55 h/week (long working hours). There were four outcomes at follow-up: (1) overweight/obesity (BMI ≥ 25 kg/m2) or (2) overweight (BMI 25–29.9 kg/m2) among participants without overweight/obesity at baseline; (3) obesity (BMI ≥ 30 kg/m2) among participants with overweight at baseline, and (4) weight loss among participants with obesity at baseline. Results Of the 61,143 participants without overweight/obesity at baseline, 20.2% had overweight/obesity at follow-up. Compared with standard weekly working hours, the age-, sex- and socioeconomic status-adjusted relative risk (RR) of overweight/obesity was 0.95 (95% CI 0.90–1.00) for part-time work, 1.07 (1.02–1.12) for 41–48 weekly working hours, 1.09 (1.03–1.16) for 49–54 h and 1.17 (1.08–1.27) for long working hours (P for trend <0.0001). The findings were similar after multivariable adjustment and in subgroup analyses. Long working hours were associated with an excess risk of shift from normal weight to overweight rather than from overweight to obesity. Long working hours were not associated with weight loss among participants with obesity. Conclusions This analysis of large individual-participant data suggests a small excess risk of overweight among the healthy-weight people who work long hours. %B International Journal of Obesity %V 44 %P 1368 - 1375 %@ 1476-5497 %G eng %! International Journal of Obesity %R 10.1038/s41366-019-0480-3 %0 Journal Article %J The Journals of Gerontology: Series A %D 2020 %T Socioeconomic Inequalities in Disability-free Life Expectancy in Older People from England and the United States: A Cross-national Population-Based Study %A Zaninotto, Paola %A G David Batty %A Stenholm, Sari %A Ichiro Kawachi %A Hyde, Martin %A Goldberg, Marcel %A Westerlund, Hugo %A Vahtera, Jussi %A Head, Jenny %K Cross-National %K Disability %K Healthy life expectancy %K socioeconomic status %X We examined socioeconomic inequalities in disability-free life expectancy in older men and women from England and the United States and explored whether people in England can expect to live longer and healthier lives than those in the United States.We used harmonized data from the Gateway to Global Aging Data on 14,803 individuals aged 50+ from the U.S. Health and Retirement Study (HRS) and 10,754 from the English Longitudinal Study of Ageing (ELSA). Disability was measured in terms of impaired activities and instrumental activities of daily living. We used discrete-time multistate life table models to estimate total life expectancy and life expectancy free of disability.Socioeconomic inequalities in disability-free life expectancy were of a similar magnitude (in absolute terms) in England and the United States. The socioeconomic disadvantage in disability-free life expectancy was largest for wealth, in both countries: people in the poorest group could expect to live seven to nine fewer years without disability than those in the richest group at the age of 50.Inequalities in healthy life expectancy exist in both countries and are of similar magnitude. In both countries, efforts in reducing health inequalities should target people from disadvantaged socioeconomic groups. %B The Journals of Gerontology: Series A %V 75 %P 906-913 %8 01 %G eng %N 5 %R 10.1093/gerona/glz266 %0 Journal Article %J Occupational and Environmental Medicine %D 2018 %T Occupational and educational inequalities in exit from employment at older ages: evidence from seven prospective cohorts %A Carr, Ewan %A Fleischmann, Maria %A Goldberg, Marcel %A Kuh, Diana %A Murray, Emily T %A Stafford, Mai %A Stansfeld, Stephen %A Vahtera, Jussi %A Xue, Baowen %A Zaninotto, Paola %A Zins, Marie %A Head, Jenny %K Education %K Employment and Labor Force %K Europe %K Health Disparities %K Work %X Objectives Past studies have identified socioeconomic inequalities in the timing and route of labour market exit at older ages. However, few studies have compared these trends cross-nationally and existing evidence focuses on specific institutional outcomes (such as disability pension and sickness absence) in Nordic countries. We examined differences by education level and occupational grade in the risks of work exit and health-related work exit. Methods Prospective longitudinal data were drawn from seven studies (n=99 164). Participants were in paid work at least once around age 50. Labour market exit was derived based on reductions in working hours, changes in self-reported employment status or from administrative records. Health-related exit was ascertained by receipt of health-related benefit or pension or from the reported reason for stopping work. Cox regression models were estimated for each study, adjusted for baseline self-rated health and birth cohort. Results There were 50 003 work exits during follow-up, of which an average of 14% (range 2-32%) were health related. Low level education and low occupational grade were associated with increased risks of health-related exit in most studies. Low level education and occupational grade were also associated with an increased risk of any exit from work, although with less consistency across studies. Conclusions Workers with low socioeconomic position have an increased risk of health-related exit from employment. Policies that extend working life may disadvantage such workers disproportionally, especially where institutional support for those exiting due to poor health is minimal. %B Occupational and Environmental Medicine %V 75 %P 369 - 377 %8 Dec-05-2018 %G eng %U http://oem.bmj.com/content/75/5/369 %N 5 %! Occup Environ Med %R 10.1136/oemed-2017-10461910.1136/oemed-2017-104619.supp1 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2015 %T Comorbidity and functional trajectories from midlife to old age: the Health and Retirement Study. %A Stenholm, Sari %A Westerlund, Hugo %A Head, Jenny %A Hyde, Martin %A Ichiro Kawachi %A Pentti, Jaana %A Mika Kivimäki %A Vahtera, Jussi %K Activities of Daily Living %K Age Factors %K Aged %K Aged, 80 and over %K Chronic disease %K Comorbidity %K Female %K Health Status %K Humans %K Longitudinal Studies %K Male %K Middle Aged %K Retirement %K Socioeconomic factors %K United States %X

BACKGROUND: The number of diseases and physical functioning difficulties tend to increase with age. The aim of this study was to examine the trajectories of physical functioning across age groups and whether the trajectories differ according to disease status in different population subgroups.

METHODS: Repeat data from a nationally representative population sample, the Health and Retirement Study, was used. Participants were 10,709 men and 13,477 women aged 60-107 years at baseline with biennial surveys from 1992 to 2010. Average length of follow-up was 10.3 years ranging from 0 to 18 years. Disease status and physical functioning was asked about at all study phases and 10 items were summed to obtain a physical functioning score (0-10).

RESULTS: Age modified the relationship between number of chronic diseases and physical functioning with older participants having more physical functioning difficulties with increasing number of diseases. An average 70-year-old participant with no diseases had 0.89 (95% CI: 0.85-0.93) physical functioning difficulties, with one disease 1.72 (95% CI: 1.69-1.76) difficulties, with two diseases 2.57 (95% CI: 2.52-2.62) difficulties, and with three or more diseases 3.82 (95% CI: 3.76-3.88) difficulties. Of the individual diseases memory-related diseases, stroke, pulmonary diseases, and arthritis were associated with significantly higher physical functioning difficulties compared with other diseases.

CONCLUSIONS: Comorbidity is associated with greater burden of physical functioning difficulties. Of the studied diseases, memory-related diseases, stroke, pulmonary diseases, and arthritis alone or in combination limit most physical functioning.

%B J Gerontol A Biol Sci Med Sci %I 70 %V 70 %P 332-8 %8 2015 Mar %G eng %U http://biomedgerontology.oxfordjournals.org/content/early/2014/07/23/gerona.glu113.abstract %N 3 %1 http://www.ncbi.nlm.nih.gov/pubmed/25060316?dopt=Abstract %2 PMC4336333 %4 Aging/Comorbidity/Physical functioning/Disability/Disability %$ 999999 %R 10.1093/gerona/glu113 %0 Journal Article %J Journal of Epidemiology and Community Health %D 2014 %T Age-related trajectories of physical functioning in work and retirement: The role of sociodemographic factors, lifestyle and disease %A Stenholm, Sari %A Westerlund, Hugo %A Salo, P. %A Hyde, Martin %A Pentti, Jaana %A Head, Jenny %A Mika Kivimäki %A Vahtera, Jussi %K Demographics %K Health Conditions and Status %K Retirement Planning and Satisfaction %X Background: Loss of physical functioning is an early marker of declining health in older people. The objective of this study was to examine the age-related trajectories of physical functioning among those in full-time work and retirement. Methods: Based on the Health and Retirement Study, participants who were working full-time or were in full-time retirement and 65-85 years of age during the follow-up period from 1992 to 2010 were included (n=17 844, n of observations from repeated measures in full-time work 5891 and in retirement 57 117). Details of physical functioning were asked about at all study phases and 10 items related to mobility and activities of daily living were summed to obtain a physical functioning score (0-10). Results: The number of physical functioning difficulties increased every 10 years by 0.17 (95 CI 0.04 to 0.29) when in full-time work and by 0.46 (95 CI 0.41 to 0.50) in retirement after adjusting for age, sex, race, education, total wealth, Body Mass Index, smoking, physical activity and number of diseases. Factors that were associated with a significantly greater increase in number of physical functioning difficulties in full-time work and retirement include lifestyle-related risks and chronic conditions. Conclusions: Physical functioning declines faster in retirement than in full-time work in employees aged 65 years or older and the difference is not explained by absence of chronic diseases and lifestyle-related risks. 2014 by the BMJ Publishing Group Ltd. %B Journal of Epidemiology and Community Health %I 68 %V 68 %P 503-509 %G eng %N 6 %4 Physical Activity/ADL/IADL/trajectories/Physical function/retirement %$ 999999 %R 10.1136/jech-2013-203555