title: Frailty, prefrailty and employment outcomes in Health and Employment After Fifty (HEAF) Study.
abstract: Demographic changes are requiring people to work longer. No previous studies, however, have focused on whether the 'frailty' phenotype (which predicts adverse events in the elderly) is associated with employment difficulties. To provide information, we assessed associations in the Health and Employment After Fifty Study, a population-based cohort of 50-65-year olds.
  
  
  
  Subjects, who were recruited from 24 English general practices, completed a baseline questionnaire on 'prefrailty' and 'frailty' (adapted Fried criteria) and several work outcomes, including health-related job loss (HRJL), prolonged sickness absence (>20 days vs less, past 12 months), having to cut down substantially at work and difficulty coping with work's demands. Associations were assessed using logistic regression and population attributable fractions (PAFs) were calculated.
  
  
  
  In all, 3.9% of 8095 respondents were classed as 'frail' and 31.6% as 'prefrail'. Three-quarters of the former were not in work, while 60% had left their last job on health grounds (OR for HRJL vs non-frail subjects, 30.0 (95% CI 23.0 to 39.2)). Among those in work, ORs for prolonged sickness absence, cutting down substantially at work and struggling with work's physical demands ranged from 10.7 to 17.2. The PAF for HRJL when any frailty marker was present was 51.8% and that for prolonged sickness absence was 32.5%. Associations were strongest with slow reported walking speed. Several associations were stronger in manual workers than in managers.
  
  
  
  Fried frailty symptoms are not uncommon in mid-life and are strongly linked with economically important adverse employment outcomes. Frailty could represent an important target for prevention.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Palmer
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: Stefania
authors.initials: S
authors.lastname: D'Angelo
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: E Clare
authors.initials: EC
authors.lastname: Harris
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: Cathy
authors.initials: C
authors.lastname: Linaker
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK.
authors.forename: Catharine R
authors.initials: CR
authors.lastname: Gale
authors.affiliation: Centre for Research on Ageing, University of Southampton, Southampton, UK.
authors.forename: Maria
authors.initials: M
authors.lastname: Evandrou
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Holly
authors.initials: H
authors.lastname: Syddall
authors.affiliation: Farr Institute, University of Manchester, Manchester, UK.|Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
authors.forename: Tjeerd
authors.initials: T
authors.lastname: van Staa
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Cooper
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|NIHR Collaboration for Leadership in Applied Health Research and Care Wessex, University of Southampton, Southampton, UK.|Institute of Neuroscience, Newcastle University, Newcastle, UK.|NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle, UK.|Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK.
authors.forename: Avan
authors.initials: A
authors.lastname: Aihie Sayer
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.|Arthritis Research UK/MRC Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.
authors.forename: Karen
authors.initials: K
authors.lastname: Walker-Bone
mesh_terms: D000368:Aged; D004651:Employment / Q000523:psychology / Q000706:statistics & numerical data*; D004739:England; D015444:Exercise; D005260:Female; D058006:General Practice; D015577:Geriatric Assessment / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D015995:Prevalence; D018582:Sick Leave / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
keywords: frail; job loss; work limitations