A key factor in a person’s fitness to work is their disability-free life expectancy
IN TERMS of the current debate about working past “normal” retirement age, Canada and Italy represent both ends of the spectrum.
In Italy, most 60 year olds no longer work in public service jobs.
Canadian seniors, on the other hand, continue to beaver away into their 70s, with advertisements in shopping malls specifically seeking out older workers for vacant posts.
So which society has got it right? Is one damaging the health of its older citizens and the other improving it?
In fact, there are conflicting health trends among older people. There are significant differences in healthy life expectancy in old age across the EU. But there are also differences within countries, reflecting the varying prevalence of disability and chronic disease.
These differences are primarily driven by risk exposures and lifestyles in earlier life and also by health inequalities.
A key factor in assessing ongoing fitness to work is a person’s disability-free life expectancy. Research from 2001 in England found that for men aged 65, their disability-free life expectancy was 8.9 years; 65-year-old women could expect to enjoy 10.2 years of “functional” life. In general, people’s intellectual capabilities are well preserved into their mid-70s, with the ability to learn new skills remaining into advanced old age.
A retrospective study of 382 people newly diagnosed with Alzheimer’s disease, carried out by researchers from the Institute of Psychiatry, found a link between retirement age and the onset of dementia, with those working longer apparently delaying the onset of the illness. And it is widely accepted that engagement with work protects against depression because it increases our social connectivity.
One Australian study found the prevalence of a range of psychological disorders diminished across increasingly older age categories. It suggested that, for men, the relationship between retirement and mental health varied with age, with young retirees more likely to experience problems.
On the other hand, researchers from the British Economic Social Research Council found that retiring early was generally good for health – unless the person had been forced to stop work for health or economic reasons. People forced to retire had poorer mental health, they found.
What about older workers’ physical health? The 2003 Health Survey for England found 81 per cent of men and 87 per cent of women aged 55 years and over did not reach the recommended levels of physical activity to benefit health. There was also a sharp decline in levels of activity with increased age. The percentage of men achieving the recommended levels of physical activity reduces from 32 per cent at 55-64 years of age, to 9 per cent of those aged 75 and older.
Everyone agrees a person’s physical capacity reduces with age. Strength, endurance, bone density and flexibility decline at a rate of about 10 per cent per decade; muscle power drops off even faster. Regular exercise actually takes on a greater significance as we grow old. Even a simple task, like rising from a chair, taxes our muscles to a much greater proportion of their residual capacity when we are old than when we are young.
Research into the effectiveness of exercise has shown that for older people the increase in muscle strength can be the equivalent of taking the muscle back in time to an age that is 15 years younger.
But we cannot simply embrace a “let’s all work till we’re 68” approach. Many diseases become more prevalent with age. And there may be a male/female divide such as that found in coronary heart disease, where the increase in incidence starts about 10 years earlier in men than in women before narrowing after age 60. However, the disability associated with heart disease appears to be reducing; this is attributed to earlier diagnosis and better treatment. It reflects a general trend whereby most people younger than 85 are seeing a postponement of limitations and disabilities despite an increase in chronic disease.
Possible solutions include the introduction of shorter working spans of 15 to 25 hours a week for older workers, reassignment to less physically demanding roles within companies and a move to less arduous shift patterns after a certain age.
But working when older cannot be seen as a homogenous challenge. The best approach is to assess an individual’s ability to continue working in a specific job. This is currently undertaken by occupational physicians in Ireland for workers and employers.
It would make sense to incorporate such expertise in planning for the influx of older workers into our economy.
In numbers:
9%: of men over 75 take recommended levels of physical activity
10.2: disability-free life expectancy years for women aged 65
10%: the rate at which strength, endurance, bone density and flexibility declines with age