title: The relationship between active ageing and health using longitudinal data from Denmark, France, Italy and England.
abstract: BACKGROUND
  'Active ageing' has been promoted as a strategy for extending quality of life and healthy life expectancy. However, there is limited evidence from nationally representative longitudinal studies on whether engagement among older adults is associated with better outcomes and few studies have considered possible bias arising from differential study attrition.
  
  
  METHODS
  We investigate associations between the engagement of people aged 50-69 in three types of activity with self-rated health and depression 2 years later using nationally representative longitudinal data from four European countries (Denmark, France, Italy and England). Data were drawn from waves 1 and 2 of the Survey of Health, Ageing and Retirement in Europe and the English Longitudinal Study of Ageing. Multivariable analysis was used to analyse associations between baseline activity and outcomes at follow-up controlling for socioeconomic, demographic and health-related variables at baseline. Multiple imputation techniques and sensitivity analyses were undertaken to investigate possible bias arising from sample attrition.
  
  
  RESULTS
  Respondents in paid work at baseline were less likely to be depressed or to report poor or fair health at follow-up than those who were 'inactive', although not in Italy. Engagement in formal and informal activities was not significantly associated with health at follow-up. Sensitivity analyses showed that assuming that those in bad health were over-represented among study attritors weakened the association between work at baseline and health at follow-up.
  
  
  CONCLUSIONS
  Engagement in paid work may help maintain health in later life, although mechanisms and contextual influences need further investigation.
authors.affiliation: Department of Social Science, Health and Medicine, School of Social Science and Public Policy, King's College London, , London, UK.
authors.forename: Giorgio
authors.initials: G
authors.lastname: Di Gessa
authors.forename: Emily
authors.initials: E
authors.lastname: Grundy
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging / Q000502:physiology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D003863:Depression / Q000453:epidemiology / Q000523:psychology; D004739:England / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006305:Health Status Indicators; D006801:Humans; D007398:Interpersonal Relations; D007558:Italy / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011788:Quality of Life; D012179:Retirement / Q000523:psychology / Q000706:statistics & numerical data; D012959:Socioeconomic Factors
keywords: Ageing; Health Status; Longitudinal Studies