Impact of employment on the elderly in a super-aging society during … – Nature.com

Out of the 144 participants analyzed in this study, 33 (22.9%) were in the employed group, whereas 111 (77.1%) were in the non-employed group. Even after adjustment for age and sex, the attention function was significantly higher in the employed group than in the non-employed group (OR: 0.96, 95% CI 0.940.99).

The attention function includes four elements: persistence, selection, transfer, and distribution. However, each element is interrelated26,27. In addition, the classification of the attention function is not standardized28. Therefore, it is challenging to examine which element of the attention function has an effect. However, the TMT-A used in this study includes visual reading ability, graphomotor speed (correct writing speed), and visual motion processing speed in addition to the four elements of the attention function29. It is proposed that since attentional functions are required for the routine execution of tasks while performing jobs, the employed group showed better attention function than the non-employed group. Similarly, there are many opportunities to process visual information and for writing while carrying out jobs. This may be attributed to improved visual reading ability and graphomotor speed depending on the type of job.

In the univariate analysis, significantly higher grip strength and SMI values in the working group could be due to the skewed malefemale ratio between the two groups. In this study, 16 out of 33 participants in the employed group were females (48.5%), whereas 87 out of 111 participants in the unemployed group (78.4%) were females. In 2018, the employment rate of the elderly by sex had been reported to be 33.2% for males and 17.4% for females, which is almost a 2:1 ratio30. According to a Cabinet Office survey, the employment rate for men over the age of 15years in Japan is 69.4% for men and 53.0% for women; this rate is slightly higher for men, but it is not as large as the difference in employment rates between men and women among the elderly31. Hence it is clear that the working scenario of males and females in Japan differs greatly between the younger and elderly generations.

In the case of other motor functions, there were no differences in walking speed, locomotive 2-step test, and frailty between the two groups. Because the type and content of employment varied, it could be speculated that the motor function was affected by the work content. In particular, of the 33 employees in the working group, 1 (3.0%) continued to work as a full-time employee, suggesting that the daily employment characteristics had little effect on motor function. In addition, a previous study reported that working individuals were associated with pre-frailty32. However, this study found no difference in the number of frail participants between the two groups. The reason for this could be the average age of the participants, which is about 3years younger than in previous studies.

The most common reason for working was found to be health (30.3%). In contrast, other surveys33 showed that the majority were working for financial reasons. The difference could be due to the participants of this study, who were interested in getting examined for motor and cognitive functions, and the recruitment was limited to those who could engage for about 1h and 30min during the daytime on weekdays. Therefore, it is difficult to generalize and examine the reasons for employment.

There are some limitations to this study. First, it was not possible to establish a causal relationship between doing paid work and the decline in attention function for a cross-sectional survey. Hence, we are conducting a follow-up survey to verify whether the attention function could be kept high by working. Second, the investigation was carried out in an emergency scenario due to the pandemic. Third, the sample size was small, and additional research is needed to generalize the results. Fourth, the lack of information on underlying diseases related to motor and cognitive function does not rule out the effects identified herein. Furthermore, although age was adjusted for in the final multivariate analysis, the effect of aging must be considered as a limitation of this study, as there is an age difference of approximately 2.6years between the two groups.

However, the impact on employment due to the emergency scenario is still unclear. Therefore, we plan to re-examine the participants and analyze the details starting from 2022.

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Impact of employment on the elderly in a super-aging society during ... - Nature.com