Mortality and risk of cardiovascular diseases by age at retirement in three Italian cohorts

The relationship between age at retirement and subsequent physical health appears still contradictory in the literature, with more recent studies suggesting possible adverse health effects linked to employment at later ages. Aim of this study was to assess the long-term risk of overall mortality and incidence of cardiovascular diseases (CVDs) associated with age at retirement in three large Italian cohorts using both survey and administrative data. The risk of mortality and CVDs associated with age at retirement, kept continuous, was assessed separately for gender using age-adjusted Cox models, further controlled for chronic morbidity, education, socioeconomic and previous working characteristics. In another analysis, age at retirement was examined treating it as a dichotomous variable, comparing, in a set of analyses with age at retirement from 52 to 65 years, the incidence of the health outcomes among subjects who retired after a certain age, compared to those who retired up to that age. Higher age at retirement was associated with significantly higher mortality among men in the three cohorts, while among women the association was not significant, although in the same direction as for men. The risk of CVDs was also significantly associated with higher age at retirement in all the datasets among men, and in two of them among women. The set of the analyses on age at retirement dichotomized confirmed the results based on continuous age at retirement for both genders. Several robustness analyses, including IV Poisson instrumental variable, confirm the validity of results for men, whereas female results were less stable and robust. Policy makers should be aware of the risk for public heath of policies that increase retirement age.