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Relationship between employment histories and frailty trajectories in later life: evidence from the English Longitudinal Study of Ageing
  1. Wentian Lu1,
  2. Rebecca Benson2,
  3. Karen Glaser3,
  4. Loretta G Platts4,
  5. Laurie M Corna3,
  6. Diana Worts5,
  7. Peggy McDonough5,
  8. Giorgio Di Gessa6,
  9. Debora Price7,
  10. Amanda Sacker1
  1. 1ESRC International Centre for Lifecourse Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
  2. 2Research Department of Epidemiology and Public Health, Institute of Epidemiology and Health Care, University College London, London, UK
  3. 3Department of Global Health & Social Medicine, Institute of Gerontology, School of Social Science and Public Policy, King's College London, London, UK
  4. 4Stress Research Institute, Stockholm University, Stockholm, Sweden
  5. 5Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  6. 6Department of Social Policy, The London School of Economics and Political Science, London, UK
  7. 7Manchester Institute for Collaborative Research on Ageing, University of Manchester, Manchester, UK
  1. Correspondence to Wentian Lu, ESRC International Centre for Lifecourse Studies in Society and Health (ICLS), Research Department of Epidemiology and Public Health, Institute of Epidemiology and Healthcare, University College London, 1-19 Torrington Place, London WC1E, 7HB, UK;{at}


Background Given the acceleration of population ageing and policy changes to extend working lives, evidence is needed on the ability of older adults to work for longer. To understand more about the health impacts of work, this study examined the relationship between employment histories before retirement and trajectories of frailty thereafter.

Methods The sample comprised 2765 women and 1621 men from the English Longitudinal Study of Ageing. We used gendered typologies of life-time employment and a frailty index (FI). Multilevel growth curve models were used to predict frailty trajectories by employment histories.

Results Women who had a short break for family care, then did part-time work till 59 years had a lower FI after 60 years than those who undertook full-time work until 59 years. Women who were largely family carers or non-employed throughout adulthood, had higher levels of frailty at 60 years but experienced a slower decline with age. Men who worked full-time but early exited at either 49 or 60 years had a higher FI at 65 years than those who worked full-time up to 65 years. Interaction between employment histories and age indicated that men in full-time work who experienced an early exit at 49 tended to report slower declines.

Conclusions For women, experiencing distinct periods throughout the lifecourse of either work or family care may be advantageous for lessening frailty risk in later life. For men, leaving paid employment before 65 years seems to be beneficial for decelerating increases in frailty thereafter. Continuous full-time work until retirement age conferred no long-term health benefits.

  • Social and life-course epidemiology

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See:

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  • Correction notice This article has been corrected since it was published Online First. Figures 1 and 2 were originally the wrong way round and have now been corrected.

  • Contributors WL and AS conceptualised and designed the study. KG, LP, LC, DW, PM, GG, DP and AS derived the history data. WL conducted the statistical analysis. WL, AS and RB interpreted the results and WL drafted the initial manuscript. AS, RB and KG commented on the draft manuscript. All authors reviewed the manuscript and approved the final version.

  • Funding This research is part of the work undertaken by the well-being, health, retirement and the lifecourse (WHERL) interdisciplinary consortium funded by the cross-research council Lifelong Health and Well-being (LLHW) programme under Extending Working Lives (ES/L002825/1). The authors alone bear responsibility for the analysis and interpretation of the data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethical approval for all the ELSA waves was granted from NHS Research Ethics Committees under the National Research and Ethics Service (NRES). For further information see:

  • Provenance and peer review Not commissioned; externally peer reviewed.

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