title: The impact of depression and diabetes mellitus on older workers' functioning.
abstract: OBJECTIVE
  Using the International Classification of Functioning, Disability and Health as a framework, this study investigates the impact of depression and diabetes mellitus on older workers' functioning (problems with concentration, physical functioning, need for recovery and work and social participation restrictions). The study focuses on how these chronic conditions, in their interaction with the work context, affect older workers' functioning, which may be an important precursor of early retirement.
  
  
  METHODS
  Older workers (≥ 45years) with depression (n=127) or diabetes mellitus (n=107) enrolled in the prospective Maastricht Cohort Study (MCS) were followed between October 2008 and October 2012. Linear, logistic and Cox regression analyses were performed to investigate the effect of these health conditions on workers' functioning compared to a reference group of older workers without a chronic condition (n=1612). The interaction with participants' working conditions (psychological job demands, decision latitude and strenuous work) was also analysed.
  
  
  RESULTS
  Compared to the reference group, depression and diabetes mellitus were (over time) positively related with need for recovery caseness and restrictions in social participation but not with restrictions in work participation. Depression was positively related with concentration problems and need for recovery, whereas diabetes mellitus was negatively related with physical functioning. Finally, the relationship between functioning and depression and diabetes mellitus depends on working conditions.
  
  
  CONCLUSIONS
  Older workers with depression or diabetes mellitus are vulnerable to losses in specific domains of functioning. The impact on functioning varies across working conditions, providing insight for disease-tailored preventive measures.
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands. Electronic address: dave.stynen@maastrichtuniversity.nl.
authors.forename: D
authors.initials: D
authors.lastname: Stynen
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: N W H
authors.initials: NW
authors.lastname: Jansen
authors.affiliation: Department of Epidemiology, CAPHRI School for Public Health and Primary Care, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
authors.forename: I J
authors.initials: IJ
authors.lastname: Kant
mesh_terms: D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D003657:Decision Making; D003863:Depression / Q000523:psychology*; D003920:Diabetes Mellitus / Q000523:psychology*; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016014:Linear Models; D008297:Male; D005082:Physical Exertion; D011446:Prospective Studies; D012959:Socioeconomic Factors; D014937:Work / Q000523:psychology*
keywords: Depression; Diabetes mellitus; Functioning; Impaired health; Need for recovery; Older worker