Depression and early retirement: prospective population based study in middle aged men.
BACKGROUND
Mental depression is an important health problem in many countries. It reduces productivity at work and is the fastest increasing reason for early retirement.


METHODS
This study followed up a Finnish cohort of 1726 men from 1984 to 2000. Depression was assessed at baseline by HPL depression score. Pension records were obtained from the national pension registers. Cox's regression analysis was used to estimate the associations of depression with the risk of all disability pensions combined, separately for different causes of disability, and non-illness based pension.


RESULTS
During the follow up, 839 men (48.6%) received a disability pension. A total of 142 men (16.9% of all disability pensions) retired because of mental disorder and of these, 75 (52.8%) because of depression. After adjustment for the potential confounders, men in the highest third of depression score had an increased risk of non-illness based pension (RR 1.86 95% CI 1.37 to 2.51) and disability pension attributable to mental disorders (RR 2.74, 95% CI 1.68 to 4.46), chronic somatic diseases (RR 1.68, 95% CI 1.05 to 2.71), cardiovascular diseases (RR 1.61, 95% CI 1.12 to 2.32). The mean age of retirement for men with a high and low depression score was 57.6 years (SD 3.87) and 59.1 years (SD 3.65) (p<0.001) respectively.


CONCLUSIONS
A high depression score predicted disability attributable to any cause, especially mental disorders, and non-illness based pensions. Depressed people retired on average 1.5 years younger than those without depression. Further studies are needed to elucidate the pathways of how mental depression leads people to seek retirement pension.
Karpansalo
M
M
Department of Public Health and General Practice, University of Kuopio, PO Box 1927, 70120 Kuopio, Finland. minna.karpansalo@medivire.fi
Kauhanen
J
J
Lakka
T A
TA
Manninen
P
P
Kaplan
G A
GA
Salonen
J T
JT
D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease; D003866:Depressive Disorder / Q000453:epidemiology*; D004185:Disability Evaluation; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D010415:Pensions; D011446:Prospective Studies; D012179:Retirement / Q000523:psychology*; D012307:Risk Factors; D013997:Time Factors