Midlife job profiles and disabilities in later life: a 28-year follow-up of municipal employees in Finland.

Purpose: Occupations during adult life may have long-term effects and subsequently increase the risk of disability in old age. We investigated the associations between job profile groups in midlife and disability in old age for women and men.

Methods: This prospective 28-year follow-up study (1981-2009) examined 2998 municipal employees (1892 women and 1106 men) aged 44-58 years at baseline. A detailed analysis of the demands of 88 occupations based on interviews and observations at the work places was made at baseline. Thirteen job profile clusters emerged. Questionnaire information on health, lifestyle and socio-demographic factors was collected at baseline. In 2009, five Activities of Daily Living and seven Instrumental Activities of Daily Living tasks were assessed. A sum score of '0-12' was calculated using 12 dichotomous tasks where '0' indicates no difficulties in any tasks and '1-12' indicates increasing disability. Negative binomial regression was used to calculate rate ratios (RR) and their 95 % confidence intervals (CIs) for disability due to midlife job profiles.

Results: After adjusting for age, socioeconomic, lifestyle and health-related characteristics, women in auxiliary (RR 2.1, 95 % CI 1.4-3.2), home care (2.1, 1.4-3.2), kitchen supervision (2.0, 1.1-3.6) and office (1.6, 1.1-2.4) job profiles had a higher risk of disability in later life than those in administrative jobs. Auxiliary (1.5, 1.1-2.9) and technical supervision (1.7, 1.1-2.7) job profiles carried an increased risk among men.

Conclusion: Midlife job profiles mainly linked with physically heavy work were strong predictors of disability in later life. In women, office work also increased the risk of disability.