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Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides.

ABSTRACT: To estimate the extent of early retirement and to examine risk factors for voluntary early retirement and disability pension in a cohort of nurses' aides.Register study including baseline questionnaire and register data covering all transfer incomes from 1991 to 2008 in a cohort of nurses' aides established in 1993 with a follow-up period of 15 years.Nurses' aides working in nursery homes, homecare or hospitals.3332 gainfully employed nurses' aides at the time of inclusion in the study.Disability pension or early voluntary retirement.16.2% of the population was granted disability pension and 27.1% entered early voluntary retirement in the follow-up period representing 11 186 lost working years with a direct cost in transfer payment amounting about €410 million. Health-related risk factors for disability pension was long-lasting low-back pain (HR 2.27(95% CI 1.55 to 3.34), sick leave because of upper-extremity disorders (HR 2.18 (95% CI 1.08 to 2.11), and inflammatory rheumatic disease (HR 2.42 (95% CI 1.67 to 3.52)). Of non-health-related factors, low education, workers compensation case, evening work and high-rated perceived exertion at work all were minor risk factors for disability pension. The primary risk factor for early voluntary retirement was low education (HR 3.19 (95% CI 2.65 to 3.85)).43.3% of nurses' aides gainfully employed in 1993 retired before due time during the follow-up period. Work-related factors at baseline only seemed to have a minor prognostic role. Risk factors for disability pension were mainly health-related factors, whereas economical factors seemed to influence the decision to choose early voluntary retirement. The number of persons and the amount of lost working years underscores the need of a more active counselling towards maintaining employment especially among those with persistent musculoskeletal disorders.

SUBMITTER: Jensen LD

PROVIDER: S-EPMC3533112 | biostudies-literature | 2012

REPOSITORIES: biostudies-literature

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Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides.

Jensen Lone Donbæk LD Ryom Pia Køhler PK Christensen Michael Victor MV Andersen Johan Hviid JH

BMJ open 20121112 6

<h4>Objective</h4>To estimate the extent of early retirement and to examine risk factors for voluntary early retirement and disability pension in a cohort of nurses' aides.<h4>Design</h4>Register study including baseline questionnaire and register data covering all transfer incomes from 1991 to 2008 in a cohort of nurses' aides established in 1993 with a follow-up period of 15 years.<h4>Setting</h4>Nurses' aides working in nursery homes, homecare or hospitals.<h4>Participants</h4>3332 gainfully ...[more]

PMID: 23148337

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Project description:BACKGROUND:We previously reported that a median of 5.6 years of intensive as compared with standard glucose lowering in 1791 military veterans with type 2 diabetes resulted in a risk of major cardiovascular events that was significantly lower (by 17%) after a total of 10 years of combined intervention and observational follow-up. We now report the full 15-year follow-up. METHODS:We observationally followed enrolled participants (complete cohort) after the conclusion of the original clinical trial by using central databases to identify cardiovascular events, hospitalizations, and deaths. Participants were asked whether they would be willing to provide additional data by means of surveys and chart reviews (survey cohort). The prespecified primary outcome was a composite of major cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, new or worsening congestive heart failure, amputation for ischemic gangrene, and death from cardiovascular causes. Death from any cause was a prespecified secondary outcome. RESULTS:There were 1655 participants in the complete cohort and 1391 in the survey cohort. During the trial (which originally enrolled 1791 participants), the separation of the glycated hemoglobin curves between the intensive-therapy group (892 participants) and the standard-therapy group (899 participants) averaged 1.5 percentage points, and this difference declined to 0.2 to 0.3 percentage points by 3 years after the trial ended. Over a period of 15 years of follow-up (active treatment plus post-trial observation), the risks of major cardiovascular events or death were not lower in the intensive-therapy group than in the standard-therapy group (hazard ratio for primary outcome, 0.91; 95% confidence interval [CI], 0.78 to 1.06; P?=?0.23; hazard ratio for death, 1.02; 95% CI, 0.88 to 1.18). The risk of major cardiovascular disease outcomes was reduced, however, during an extended interval of separation of the glycated hemoglobin curves (hazard ratio, 0.83; 95% CI, 0.70 to 0.99), but this benefit did not continue after equalization of the glycated hemoglobin levels (hazard ratio, 1.26; 95% CI, 0.90 to 1.75). CONCLUSIONS:Participants with type 2 diabetes who had been randomly assigned to intensive glucose control for 5.6 years had a lower risk of cardiovascular events than those who received standard therapy only during the prolonged period in which the glycated hemoglobin curves were separated. There was no evidence of a legacy effect or a mortality benefit with intensive glucose control. (Funded by the VA Cooperative Studies Program; VADT ClinicalTrials.gov number, NCT00032487.).

Dataset Information

Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides.

Publications

Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides.

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