Sickness absence and/or disability pension and future work income after age 65 and 70 in Sweden

BACKGROUND: As retirement ages are increasing in Europe, more knowledge is needed on factors that are associated with extended working life. Our aim was to explore if prior sickness absence (SA) and/or disability pension (DP) due to mental and/or somatic diagnoses were associated with income from work after age 65 and 70, respectively. METHODS: A 4-year prospective population-based cohort study using microdata from nationwide registers. We included all who in 2014 were aged 65-69 (cohort A; n = 201,263) and ≥70 (cohort B; n = 93,751), respectively, had income from work in 2014 (baseline), and lived in Sweden in 2010-2015. Cox proportional hazard regression was used to calculate hazard ratios (HR) with 95% confidence intervals (CI) for associations between prior SA (in spells >14 days) and/or DP due to mental and/or somatic diagnoses, overall and stratified by the number of net days (2010-2014), and future years with income from work (2015-2018), censored for death and emigration, adjusted for sociodemographic and work-related factors, and stratified by sex. RESULTS: The majority had no SA or DP during the exposure interval (cohort A 66.3% women, 75.8% men; cohort B 96.8% women, 97% men). Many had income from work at some point during follow-up (cohort A 77.8% women, 81.6% men, cohort B 81.9% women, 83.4% men). Prior somatic SA/DP was associated with a marginally but significantly higher HR for earlier exit from paid work in cohort A (women 1.08; 95% CI: 1.06-1.10; men 1.10; 1.08-1.12), lower HR for men in cohort B (0.93; 0.86-0.99), and non-significant HR for women in cohort B. The corresponding association for mental SA/DP was significant only for women in cohort A (1.09; 1.06-1.13). CONCLUSIONS: The likelihood of earlier exit from paid work was slightly higher for those aged 65-69 at baseline with prior somatic SA/DP, but lower for men aged ≥70 at baseline with prior somatic SA/DP. Prior mental SA/DP was associated with earlier exit only for women aged 65-69 at baseline. KEY MESSAGES: • Prior SA/DP was in many cases marginally but significantly associated with future income from work. The direction of association differed depending on the diagnosis of the spell, cohort and sex. • More knowledge is needed on how older workers with different types of morbidities and functional limitations can extend their working life in Sweden as well as in other European countries.