Abstract
ObjectiveWe examined whether socioeconomic and psychosocial adversity in midlife predicts post-retirement depressive symptoms.Design and SettingA prospective cohort study of British civil servants who responded to a self-administered questionnaire in middle-age and at older ages, 21 years later.ParticipantsThe study sample consisted of 3,939 Whitehall II Study participants (2,789 men, 1,150 women; mean age 67.6 years at follow-up) who were employed at baseline and retired at follow-up.MeasurementsMidlife adversity was assessed by self-reported socioeconomic adversity (low occupational position; poor standard of living) and psychosocial adversity (high job strain; few close relationships). Symptoms of depression post-retirement were measured by the Center for Epidemiologic Studies Depression scale.ResultsAfter adjustment for sociodemographic and health-related covariates at baseline and follow-up, there were strong associations between midlife adversities and post-retirement depressive symptoms: low occupational position (odds ratio [OR]: 1.70, 95% confidence interval [CI]: 1.15–2.51), poor standard of living (OR: 2.37, 95% CI: 1.66–3.39), high job strain (OR: 1.52, 95% CI: 1.09–2.14), and few close relationships (OR: 1.51, 95% CI: 1.12–2.03). The strength of the associations between socioeconomic, psychosocial, work-related, or non-work related exposures and depressive symptoms was similar.ConclusionsRobust associations from observational data suggest that several socioeconomic and psychosocial risk factors for symptoms of depression post-retirement can be detected already in midlife.
Highlights
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In the model adjusted for age, sex, and length of follow-up, all midlife socioeconomic and psychosocial adversities predicted symptoms of depression post-retirement; the corresponding odds ratios varied between 1.49 and 3.47
Of participants in low occupational positions and among those who reported a poor standard of living, 22.7% and 25.5%, respectively, had depressive symptoms 21 years later
Summary
We examined whether socioeconomic and psychosocial adversity in midlife predicts post-retirement depressive symptoms. There is some evidence that social inequalities in physical health, indexed as self-rated general health,[19] mental wellbeing,[20] and mortality,[21] may persist after retirement and that stress at work predicts poorer postretirement mental and physical well-being.[22] To the best of our knowledge there has been no study of post-retirement depressive symptoms as an outcome In any such investigation the contribution of poor physical health and health risk behaviors in old age should be taken into account as they are plausible sources of confounding or reverse causation given that depression, physical diseases, and health risk behaviors tend to cluster in the same individuals. We used data from the Whitehall II cohort to examine whether midlife socioeconomic and psychosocial adversity is associated two decades later with symptoms of depression post-retirement, and whether any observed associations are attributable to midlife mental health and post-retirement sociodemographic factors, physical health, and health risk behaviors
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