Reasons for retirement in older adults with osteoarthritis

Abstract

Background: Osteoarthritis begins to emerge as a major cause of functional limitation, work disability and retirement from age 50 years onwards. With policies encouraging extensions to working life, older workers with osteoarthritis will be expected to delay retirement and continue working. Identifying approaches to sustain employment for those with osteoarthritis is a priority. The aims of this study were to identify (i) reasons for retirement and factors that could have prevented retirement that were more common in those with osteoarthritis than those without and (ii) within those with osteoarthritis which factors differed by sex or occupational status.

Methods: Analysis of 2,389 retired adults who completed a postal questionnaire; mean age 71 years; 56% female. Osteoarthritis was defined by primary care consultation for osteoarthritis and the report of moderate/extreme pain interference in the questionnaire. The questionnaire collected information on sixteen reasons for retirement and eight factors that could have enabled responders to continue working. Differences between those with/without osteoarthritis, and within those with osteoarthritis by sex and occupational status (manual/non-manual) were examined using percentage difference with 95% confidence interval.

Results: 778 (32.6%) participants had osteoarthritis. Those with osteoarthritis were more likely to indicate that joint pain (24% cf 5%; % difference 19.0%; 95%CI 15.9%, 22.3%)) and comorbidity (23% cf 9%; 14% (10.8%, 17.3%)) as reasons for retirement and that less physical demands (30% cf 18%; 11.9% (8.2%, 15.7%) would have enabled them to stay in work, than those that did not have osteoarthritis. Workplace and job related factors (e.g. job stress, workplace adaptation, support from colleagues) were not commonly reported (>10%) as reasons for retiring in those with or without osteoarthritis. In those with osteoarthritis, men were significantly more likely to have retired due to comorbidity (28% cf 19%; 8.3% (2.3%, 14.4%)) and for financial incentives (24.3% cf 7.1%; 8.3% (2.3%,14.4%)). Women were more likely to have retired to spend more time with family (12.3% cf 4.0; 8.3% (4.5%, 12.0%)) and because they had reached retirement age (33.2% cf 23.1%; 10.1% (3.7%, 16.3%)). Those who had worked in manual occupations were more likely to have retired due to joint pain (26.9% cf 20.0%; 6.9% (0.8%,12.7%)). Those who had worked in non-manual occupations were more likely to have retired because they could afford to (10.8% cf 5.1%; 5.7% (1.9%, 9.9%).

Conclusion: Whilst the need for more positive workplaces to facilitate work participation is important, in this study, they were not readily reported as reasons for retirement. Those who had retired and had osteoarthritis were more likely to state that comorbidity and joint pain were key factors. Differences by sex and occupation indicate that strategies must address a wide range of reasons to maintain work participation for older workers with osteoarthritis.