Health effects of employment initiation and retirement in later life among Japanese older adults: A longitudinal study

OBJECTIVES: To examine the effects of employment initiation and retirement on physical and mental health among older adults in Japan, using three waves of cohort data and inverse probability of treatment weighting (IPTW). STUDY DESIGN: Longitudinal study. METHODS: This study included 1477 community-dwelling older Japanese adults. Working status was assessed at baseline (T0) and at the first follow-up (T1; 30 months) and categorised into four groups: (1) Never (not working at T0 and T1), (2) Initiation (not working at T0, working at T1), (3) Retirement (working at T0, not working at T1), and (4) Continuation (working at both T0 and T1). Outcomes were assessed at the second follow-up (T2; 80 months): incident frailty and incident depressive symptoms. Binary regression models weighted by IPTW were used to estimate the effects of employment transitions on health outcomes. RESULTS: Compared with participants who never worked, those who initiated employment had a significantly lower risk of frailty onset (OR = 0.90, 95% CI = 0.82-0.99) and depressive symptom onset (OR = 0.85, 95% CI = 0.75-0.96). In contrast, retirement, compared with continued employment, was not significantly associated with either outcome. CONCLUSIONS: Employment initiation was associated with a lower risk of developing both frailty and depressive symptoms. In contrast, retirement was not significantly associated with health outcomes. These findings suggest that initiating employment in later life may be associated with better health status and that retirement may not inherently lead to adverse health outcomes.