title: Late-career unemployment and all-cause mortality, functional disability and depression among the older adults in Taiwan: A 12-year population-based cohort study.
abstract: To evaluate whether late-career unemployment is associated with increased all-cause mortality, functional disability, and depression among older adults in Taiwan.
  
  
  
  In this long-term prospective cohort study, data were retrieved from the Taiwan Longitudinal Study on Aging. This study was conducted from 1996 to 2007. The complete data from 716 men and 327 women aged 50-64 years were retrieved. Participants were categorized as normally employed or unemployed depending on their employment status in 1996. The cumulative number of unemployment after age 50 was also calculated. Logistic regression analysis was used to examine the effect of the association between late-career unemployment and cumulative number of late-career unemployment on all-cause mortality, functional disability, and depression in 2007.
  
  
  
  The average age of the participants in 1996 was 56.3 years [interquartile range (IQR)=7.0]. A total of 871 participants were in the normally employed group, and 172 participants were in the unemployed group. After adjustment of gender, age, level of education, income, self-rated health and major comorbidities, late-career unemployment was associated with increased all-cause mortality [Odds ratio (OR)=2.79; 95% confidence interval (CI)=1.74-4.47] and functional disability [OR=2.33; 95% CI=1.54-3.55]. The cumulative number of late-career unemployment was also associated with increased all-cause mortality [OR=1.91; 95% CI=1.35-2.70] and functional disability [OR=2.35; 95% CI=1.55-3.55].
  
  
  
  Late-career unemployment and cumulative number of late-career unemployment are associated with increased all-cause mortality and functional disability. Older adults should be encouraged to maintain normal employment during the later stage of their career before retirement. Employers should routinely examine the fitness for work of older employees to prevent future unemployment.
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.
authors.forename: Wei-Min
authors.initials: WM
authors.lastname: Chu
authors.affiliation: School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Wen-Chun
authors.initials: WC
authors.lastname: Liao
authors.affiliation: School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Chi-Rong
authors.initials: CR
authors.lastname: Li
authors.affiliation: School of Nursing, Chung Shan Medical University, Taichung, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Shu-Hsin
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan; Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan; School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
authors.forename: Yih-Jing
authors.initials: YJ
authors.lastname: Tang
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Armed Force General Hospital, Taichung, Taiwan.
authors.forename: Hsin-En
authors.initials: HE
authors.lastname: Ho
authors.affiliation: Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; Instiute of Population Sciences, National Health Research Institutes, Miaoli County, Taiwan; School of Public Health, National Defense Medical Center, Taipei, Taiwan. Electronic address: mcl@taic.doh.gov.tw.
authors.forename: Meng-Chih
authors.initials: MC
authors.lastname: Lee
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D014478:Unemployment / Q000706:statistics & numerical data*
keywords: Depression; Disability; Elderly; Mortality; Unemployment