OBJECTIVE: To estimate the hazard ratio for disability pension associated with shift work. METHODS: Cohorts of shift and day workers were identified in three waves of the Danish Work Environment Cohort Study and followed up for incidence of disability pension in a national register of social transfer payment. A total of 3980 female and 4025 male employees were included in the cohorts. Information about shift work status, age, smoking habits, body mass index and ergonomic work environment were updated according to responses in subsequent waves of the survey when possible. Respondents reporting shift work were classified as shift workers in the following waves as well. Respondents were followed in the register from the time of first interview and were censored at the time of their 60th birthday, emigration, death or end of follow-up (18 June 2006). The authors used the Cox proportional hazards model to estimate hazard ratios for incidence of disability pension and 95% confidence intervals. RESULTS: The authors observed 253 new disability pensions among women and 173 among men during 56 903 and 57 886 person-years at risk respectively, Among women, shift work predicted disability after adjustment for age, general health and socioeconomic status HR 1.39 (95% CI 1.07 to 1.82). After further adjustment for body mass index, smoking habits, socioeconomic status and ergonomic exposures the association remained statistically significant HR 1.34 (95% CI 1.02 to 1.75). Shift work was not associated with disability among men. CONCLUSION: Shift work might be moderately associated with disability pension among women; however, more powerful studies are needed to establish the possible association.
The goal of this study was to identify measures to facilitate access to the Quebec Breast Cancer Screening Program for women with activity limitations, considering the barriers to screening uptake in that population.
The study was carried out in three stages. First, 124 semi-structured interviews were conducted in five regions of Quebec with five groups of key informants. The content analysis lead to the identification of 64 proposals, which were submitted to 31 experts through a two-round Delphi survey process. Finally, consultations were held with 11 resource people to determine which decision-making levels (local, regional, provincial) could play a key role in implementing the proposals.
A strong consensus (=80%) was achieved for 25 proposals seen as highly relevant and feasible.
The implementation of such proposals could substantially improve access to screening, given the prevalence of activity limitations in the age group targeted by the program.
As a result of conducted research on the indicators and the structure of disability caused by musculoskeletal system and connective tissue deseases, the following was found: the number of disabled people reduced by 52,9% from 2007 to 2016; the level of disability descended more than two times; in the structure of primary disability there is a prevalence of working-aged persons (52,8%), whereas their number reduced by 45% within 10 years. Persons above the working age accounted for 47,2% of the disability structure and their number fell by 60,6% within the analysed period. The highest level of disability was detected among persons above the working age, however, within last ten years it decreased more than three times. In the cohort of people disabled due to deseases mentioned above, persons with 3rd group of disability prevailed (72,7%) with the highest level of disability shown as 4,9 persons out of 10 000 the corresponding population.
Population aging increases the need for knowledge on positive aspects of aging, and contributions of older people to their own wellbeing and that of others. We defined active aging as an individual's striving for elements of wellbeing with activities as per their goals, abilities and opportunities. This study examines associations of health, health behaviors, health literacy and functional abilities, environmental and social support with active aging and wellbeing. We will develop and validate assessment methods for physical activity and physical resilience suitable for research on older people, and examine their associations with active aging and wellbeing. We will examine cohort effects on functional phenotypes underlying active aging and disability.
For this population-based study, we plan to recruit 1000 participants aged 75, 80 or 85 years living in central Finland, by drawing personal details from the population register. Participants are interviewed on active aging, wellbeing, disability, environmental and social support, mobility, health behavior and health literacy. Physical activity and heart rate are monitored for 7 days with wearable sensors. Functional tests include hearing, vision, muscle strength, reaction time, exercise tolerance, mobility, and cognitive performance. Clinical examination by a nurse and physician includes an electrocardiogram, tests of blood pressure, orthostatic regulation, arterial stiffness, and lung function, as well as a review of chronic and acute conditions and prescribed medications. C-reactive protein, small blood count, cholesterol and vitamin D are analyzed from blood samples. Associations of factors potentially underlying active aging and wellbeing will be studied using multivariate methods. Cohort effects will be studied by comparing test results of physical and cognitive functioning with results of a cohort examined in 1989-90.
The current study will renew research on positive gerontology through the novel approach to active aging and by suggesting new biomarkers of resilience and active aging. Therefore, high interdisciplinary impact is expected. This cross-sectional study will not provide knowledge on temporal order of events or causality, but an innovative cross-sectional dataset provides opportunities for emergence of novel creative hypotheses and theories.
The disability of the population of the able-bodied age causes an essential social-and-economic damage to society, because the whole "labor resource" and "the resource" ensuring the reproduction of new generations are concentrated within the mentioned life age interval. A 9-year profound study of the primary disability among the citizens of the Perm Region led to defining the main regularities and trends of prevalence and of causes of getting disabled. A forecast of the process of the able-bodied population getting disabled was made until 2005 for the whole region and for the main categories of diseases; solutions to resolving the discussed problem are defined.
We tested the hypothesis that age is a prognostic factor with respect to long-term accumulation of disability in multiple sclerosis (MS).
Kaplan-Meier analysis and binary logistic regression models determined the effect of age at disease onset, age at onset of progression, and current age on attainment of severe disability levels (Disability Status Scale [DSS] 6-8-10) from the London, Ontario, database (n = 1,023).
Older age at relapsing-remitting (RR) phase onset was associated with higher risk of reaching advanced DSS scores. This was independent of disease duration and early relapse frequency but secondary to increased risk of conversion to secondary progressive (SP) MS. Onset at age 40 (odds ratio [OR] = 4.22) and at age 50 (OR = 6.04) doubled and tripled risks of developing SP, compared to age 20 (OR = 2.05). Younger age at conversion to SPMS was associated with shorter times to high DSS scores from disease onset. The progressive course, unaffected by age at RR onset, was only modestly affected by age at SP onset. Among primary progressive and RR/SP patients, median ages at attainment of DSS scores were strikingly similar: DSS = 6, 49 vs 48 years; DSS = 8, 58 vs 58 years; and DSS = 10, 78 years for both (p = NS for all comparisons).
Development of SP is the dominant determinant of long-term prognosis, independent of disease duration and early relapse frequency. Age independently affects disability development primarily by changing probability and latency of SP onset, with little effect on the progressive course.
The influence of air pollution on disability days in Toronto during the period 1994-1999 was examined using data from Canada's National Population Health Survey. A model of disability days (the sum of days spent in bed and days when the respondent cut down on usual activities) during the 2 weeks prior to the interview was constructed by sequentially examining the influence of time period, personal characteristics, weather, and air pollution. After adjusting for these other factors, only the effects of carbon monoxide and particulate matter of median diameter less than 2.5 microm (PM2.5) were statistically significant (respectively, 30.8% (95% CI 1.2-69.0) and 21.9% (95% CI 3.8-43.0) increase in disability days for a change in concentration equal to the interquartile range of the 2-week average pollutant concentration). PM2.5 was more strongly associated with disability days in the warm season. Results of multipollutant models were difficult to interpret in that effect sizes appeared to be influenced by covariation among pollutants. With the exception of warm season results for PM2.5, findings were not sensitive to alternative analytical approaches. While these results are suggestive of significant effects of the urban air pollution mix at relatively low ambient concentrations, the precise contribution of individual pollutants could not be determined.
We investigated the association between weekly alcohol consumption and binge drinking and the risk of unemployment, sickness absence and disability pension.
Prospective register-based cohort study.
A sample of 17?690 men and women, aged 18-60 years from the Danish Health and Morbidity Survey in 2000, 2005 and 2010 participated in the study. Participants worked the entire year prior to baseline.
Administrative registers were used to obtain information on unemployment, sickness absence and disability pension during a 5-year follow-up period. Data were analysed by multivariate Cox regression model with random effect (frailty) adjusted for cohabitation status, educational level, Charlson comorbidity index, smoking habits, calendar year and geographic region.
Among males, adjusted hazards ratios (HR) of unemployment were 1.24 (95% CI 1.05-1.46, P = 0.01), 1.28 (95% CI 1.04-1.59, P =0.02) and 1.48 (95% CI 1.21-1.81, P = 0.00) respectively, for abstainers and those with alcohol consumption of 21-27 and = 28 drinks per week when compared with individuals who had 1-13 drinks per week. Corresponding HRs for sickness absence were 1.16 (95% CI 1.02-1.33, P = 0.03), 1.02 (95% CI 0.85-1.23, P = 0.84), and 1.23 (95 % CI 1.04-1.46, P = 0.02). Male abstainers had increased HR for subsequently receiving disability pension. Female abstainers had increased HR of unemployment, sickness absence and disability pension compared to women with moderate alcohol consumption. Binge drinking was associated with higher HR of unemployment compared to non-binge drinking in women: HR of 1.21 (95 % CI 1.03-1.41, P = 0.02).
In Danish men aged 18-60, alcohol abstinence and heavy consumption is associated with increased subsequent risk of unemployment and sickness absence compared with low consumption. In Danish women abstainers have increased risk of unemployment, sickness absence and disability pension, while binge drinkers are more likely to become unemployed subsequently.