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PubMed1996

Body mass index and disability pension in middle-aged men--non-linear relations.

BACKGROUND: Obesity has, in a number of studies, been found to correlate to disability and mortality, primarily due to diseases of the circulatory and musculoskeletal systems. In addition, an excess mortality among underweight subjects has been observed in previous studies. METHODS: Five complete birth-year cohorts (1926-1930) of male residents in Malmö (n = 7697) were invited to the survey at the Department of Preventive Medicine, Malmö General Hospital, and 5926 (77%) attended with complete data. Each subject was followed from inclusion, defined by the date of examination, until the end of the calendar year when he turned 58, a total study period of approximately 11 years. Data on about 300 questionnaire items and laboratory tests were determined at the health survey visit. Nationwide Swedish data registers were used for surveillance. RESULTS: Of the participants, 4.7% were underweight, 37.7% overweight, 7.3% obese and 50.3% normal weight; 849 (14.3%) had been granted disability pension at the end of follow-up, 717 after screening. After adjustment for smoking there was a J-shaped relation between body mass index (BMI) and incidence of disability pension, the relative risk ( with the normal group as reference) among underweight men being 1.9. For the overweight subjects it was 1.3 and for the obese 2.8, all differences were significant. Disease of the musculoskeletal and circulatory systems and mental disorders accounted for 67.2% of all main diagnoses resulting in disability pensions during follow-up. A total of 377 (6.4%) men died during follow-up. Diseases of the circulatory system, neoplasms, injury/poisoning and diseases of the respiratory system accounted for 91.8% of the deaths. CONCLUSIONS: Both underweight, overweight and obesity were related to risk of disability pension, with a J-shaped risk relationship.

Body Mass Index↗
PubMed1988

Differential mortality among semiskilled applicants of disability pension.

The mortality experience among 4,440 applicants for disability pension has been examined during a period of observation of ten years. All applicants were males and had been member of the Danish Semiskilled Workers' Union. The reference group consists of age matched male members of the same union. The applicants for disability pension experienced a considerable excess mortality when compared with the reference group. The higher mortality risk is still present more than ten years after the application has been settled. The persons who were refused disability pension experienced an elevated mortality, too. In opposition to previous studies it is not found informative to put forward a common estimate of the elevated mortality rate because the group of disability applicants is very heterogeneous concerning their mortality experience; the excess mortality is most elevated among persons granted the high level pension, among the youngest, and during the period closest to the award.

Adult↗
PubMed2006

Primary care consultation, hospital admission, sick leave and disability pension owing to neck and low back pain: a 12-year prospective cohort study in a rural population.

BACKGROUND: Neck and low back pain are common musculoskeletal complaints generating large societal costs in Western populations. In this study we evaluate the magnitude of long-term health outcomes for neck and low back pain, taking possible confounders into account. METHOD: A cohort of 2,351 Swedish male farmers and rural non-farmers (40-60 years old) was established in 1989. In the first survey, conducted in 1990-91, 1,782 men participated. A 12-year follow-up survey was made in 2002-03 and 1,405 men participated at both times. After exclusion of 58 individuals reporting a specific back diagnosis in 1990-91, the study cohort encompassed 1,347 men. The health outcomes primary care consultation, hospital admission, sick leave and disability pension were assessed in structured interviews in 2002-03 (survey 2). Symptoms and potential confounders were assessed at survey 1, with the exception of rating of depression and anxiety, which was assessed at survey 2. Multiple logistic regression generating odds ratios (OR) with 95% confidence intervals (95% CI) was performed to adjust the associations between reported symptoms and health outcomes for potential confounders (age, farming, workload, education, demand and control at work, body mass index, smoking, snuff use, alcohol consumption, psychiatric symptoms and specific back diagnoses during follow up). RESULTS: Of the 836 men reporting current neck and/or low back pain at survey 1, 21% had had at least one primary care consultation for neck or low back problems, 7% had been on sick leave and 4% had disability pension owing to the condition during the 12 year follow up. Current neck and/or low back pain at survey 1 predicted primary care consultations (OR = 4.10, 95% CI 2.24-7.49) and sick leave (OR = 3.22, 95% CI 1.13-9.22) after potential confounders were considered. Lower education and more psychiatric symptoms were independently related to sick leave. Lower education and snuff use independently predicted disability pension. CONCLUSION: Few individuals with neck or low back pain were on sick leave or were granted a disability pension owing to neck or low back problems during 12 years of follow up. Symptoms at baseline independently predicted health outcomes. Educational level and symptoms of depression/anxiety were important modifiers.

Adult↗
PubMed2001

Pensioners' political parties in Israel.

Involvement and participation of older persons in politics and political systems reflect the extent to which they are integrated into their society. During the last two decades, political parties of pensioners have emerged in a number of countries, including Israel, and have run candidates in national elections. If only 10% of those aged 65 and older had voted for pensioners' parties in Israel, they would have qualified for two "pensioners" seats in the Knesset (Israel's parliament). However, they suffered complete defeat, as has been the case in most other countries. This article first describes the phenomenon of pensioners' political parties in Israel, examines the circumstances around their emergence, and presents their goals. Second, it identifies and analyzes the causes for their political defeat. Third, it discusses alternatives to political parties to promote the interests of the older population. Finally, implications for further research are raised.

Aged↗
PubMed2007

Motivating disability pensioners with back pain to return to work--a randomized controlled trial.

OBJECTIVE: To investigate the outcome of a brief vocational-oriented intervention aiming to motivate disability pensioners with back pain to return to work, and to evaluate prognostic factors for having entered a return to work process during the following year. DESIGN: A randomized controlled trial was conducted. SUBJECTS: Participants (n = 89) (mean age 49 years, 65% women) who had received disability pension for more than one year were randomized into an intervention group (education, reassurance, motivation, vocational counselling, n = 45) and a control group (n = 44). METHODS: Primary outcome measures were return to work or having entered a return to work process. Secondary outcome measures were life satisfaction, disability, fear avoidance behaviour and expectancy. RESULTS: The intervention had no statistically significant effect on return to work or having entered a return to work process at 1-year follow-up. Twice as many in the intervention group (n = 10, 22%) had entered a return to work process compared with the controls (n = 5, 11%). The number needed to treat was 9.2 (95% confidence interval (CI) = 3.4, Inf). Only minor differences in secondary outcome measures were demonstrated. Positive expectancy, better physical performance and less pain were related to return to work. CONCLUSION: The effort of returning disability pensioners to work by a brief vocational-oriented intervention may be of clinical relevance. The effect needs to be explored further in larger samples of disability pensioners.

Adult↗
PubMed1976

Alcohol problems among male disability pensioners.

The study covers two materials from Malmö: 1. All 235 men who were granted temporary or permanent disability pension for the first time in 1964. 2. A group of 235 men randomly chosen from the 893 men who were granted temporary or permanent disability pension for the first time in 1974. In both materials, the number of convictions for drunkenness during the period 1932-74 was about 4.5 times as high as for Swedish men of the same age. One pensioner in three had been convicted. During the period 1939-74, one pensioner in ten in each material had been subjected to compulsory treatment by Temperance Boards.

Age Factors↗
PubMed2003

[Satisfaction of need for health services among pensioners with reformed health care].

The objective of this study was to determine the demand for health services and to assess the level of satisfaction of these needs in the new, reformed health care system with reference to pensioners and old age pensioners. The survey was carried out over the period of 4 months among patients undergoing a cure in the Municipal Sanatorium in Nałeczów. The group consisted of people with chronic diseases, among which cardiovascular system diseases were the leading ones. All the respondents were pension services users. The study results show that patients at older age, chronically ill or disabled, limited the realization of their health needs and did not begin proper treatment, due to difficult access to health services and bad financial situation. The changes introduced in the functioning of health system during the reform period did not trigger the improvement of medical care in the population of pensioners.

Aged↗
PubMed2004

[Comparison of the first medical assessment for rehabilitation benefits and disability pension in Iceland September 1st 1999 to November 30th 2003.].

AIMS: To evaluate the main characteristics which differentiate between those who are considered to benefit from rehabilitation and those for whom disability pension is thought more appropriate. MATERIAL AND METHODS: The study includes all those fulfilling the medical criteria for rehabilitation benefits or full disability pension in their first assessment at the State Social Security Institute of Iceland between September 1st 1999 and November 30th 2003. RESULTS: Rehabilitation benefits were mainly awarded in younger age groups; disability pension in older age groups. Mental and behavioural disorders were the most common medical reasons for granting rehabilitation benefits among both genders, followed by disorders of the musculoskeletal system and connective tissue, malignant neoplasms and injuries. Among females disorders of the musculoskeletal system and connective tissue were the most common medical reason for granting full disability pension, but this group of disorders was a less common reason for rehabilitation benefits. Those who fulfilled the medical criteria for rehabilitation benefits due to disorders of the musculoskeletal system and connective tissue were markedly older than those who fulfilled the medical criteria for rehabilitation benefits due to mental and behavioural disorders. CONCLUSION: In Iceland rehabilitation benefits are most likely to be awarded to relatively young claimants suffering from psychiatric disorders.

English Abstract↗
PubMedDate not supplied

Chronic toxic encephalopathy among house painters with disability pension.

Among a group of 14 painters accorded a disability pension, 11 showed signs and symptoms of slight encephalopathy. Five of these 11 painters previously had been pensioned with a diagnosis of musculoskeletal disease, while the encephalopathy was unrecorded in the disability pension records. The combined effect of the two diseases may have caused the disability. We considered occupational solvent exposure the most probable cause of the encephalopathy in four of these five painters. This study indicates that case-referent studies based on diagnoses from disability pension registers may lead to underestimation of the risk of toxic encephalopathy.

Aged↗
PubMed1996

Fibromyalgia outcome: the predictive values of symptom duration, physical activity, disability pension, and critical life events--a 4.5 year prospective study.

Forty-four fibromyalgia patients were followed through 4.5 years to assess the extent to which symptom duration, physical activity level, disability pensions, and the occurrence of critical life events would predict long-term outcome. Outcome measures included pressure tenderness (dolorimeter score), work capacity (ergometer cycle test), global subjective improvement (verbal rating scale), and visual analogue scale ratings of pain, disturbed sleep, lack of energy, and depression. Significant outcome predictors were identified by means of separate multiple regression analyses on each outcome measure at follow-up, using symptom duration, physical activity level, disability pension status, and occurrence of critical life events as independent variables, together with baseline symptom intensity and age, which were adjusted for. An adequate physical activity level and increasing age predicted a positive outcome, while receiving a permanent disability pension or having experienced an excess of major negative life events predicted a negative outcome. Symptom duration did not affect outcome.

Adult↗
PubMed1998

Sociodemographic predictors of treatment outcome in chronic non-malignant pain patients. Do patients receiving or applying for disability pension benefit from multidisciplinary pain treatment?

The present study investigated the ability of sociodemographic variables to predict the short-term effect of multidisciplinary pain treatment in 286 chronic non-malignant pain patients consecutively referred to a Danish multidisciplinary pain centre. At inclusion and 3 and 6 months later the patients' pain and health related quality of life (HRQL) was assessed using self-administered questionnaires. Sociodemographic variables measured were: age, gender, educational level, civil status, employment status and disability pension (DP) status. Intensity of pain was measured using a VAS scale. HRQL was evaluated using the Medical Outcome Study-Short Form (SF-36) and the Psychological General Well-Being Scale (PGWB). Drop out was 30% after 6 months, leaving 170 patients for the study of treatment effects. Among the sociodemographic variables evaluated only retirement pension (RP) and DP-status seemed to be significant outcome predictors: six months after inclusion, patients on RP (patients >68 years, n = 40) reported larger pain reduction (30 mm on the VAS scale) than patients < or =68 years (8 mm on the VAS scale)(P = 0.001). Patients applying for DP-pension (n = 26) did not improve. Patients on DP (n = 54) and patients not receiving DP (n = 50) obtained moderate improvements, but the improvements were significantly larger than the improvements observed in the ApplyDP-group (P = 0.05). The same pattern was seen for changes in psychological well-being (PGWB) and social functioning (SF36-SFA). No improvements were obtained in SF36-Physical functioning scores. DP-status predicted improvement in pain and social functioning even when controlling for the effect of other demographic variables, pain intensity and HRQL at referral. The present study indicates that the multidimensional problems experienced by patients applying for DP are dominated by socioeconomic factors. Focus on solving these socioeconomic problems is important if chronic pain patients are to benefit from multidisciplinary pain treatment.

Adult↗
PubMed2001

The relation between self-rated health, socioeconomic status, body mass index and disability pension among middle-aged men.

The aim of this study was to assess the relations between self-rated health (SRH), socioeconomic status (SES), body mass index (BMI) and disability pension. Five birth-year cohorts of middle-aged male residents in Malmö, Sweden, were invited and 5313 with complete data constituted the cohort in this study. Each subject was followed for approximately 11 years. Of all subjects, 73% perceived their health as perfect and among obese men and blue collar workers, the corresponding figures were 67 and 68% respectively. The adjusted odds ratios for SRH less than perfect was 1.3 (CI: 1.1-1.7) for obese subjects and 1.7 (CI: 1.5-1.9) for blue collar workers. The interaction between low SES and obesity was estimated to 11% which was not statistically significant. The adjusted relative risks (RR) of disability pension was 3.3 for subjects with SRH less than perfect, 2.2 for blue collar workers and 2.0 for obese subjects, all statistically significant and only marginally less than the crude RR. Thus, SRH among middle-aged men was associated with obesity as well as low SES, but no evidence of synergism between obesity and low SES in relation to SRH was found. Furthermore, poor SRH in particular, but also low SES and obesity, independently predicted disability pension.

Body Mass Index↗
PubMed1999

Drink driving and criminal behaviours as risk factors for receipt of disability pension and sick leave: a prospective study of young men.

AIM: To examine the extent to which drink driving and criminal behaviour would predict receipt of disability pension and high sickness absence rates in young and middle-aged men. DESIGN AND SETTING: A total of 8122 mandatory conscripts, born in 1950 or 1951, from the County of Stockholm were followed in a 22-year longitudinal study. Information was collected at the time of conscription for military service in 1969 and 1970. Data were linked to records on driving while intoxicated (DWI) and other criminal offences between 1970 and 1991 and to information from the Social Insurance Board. FINDINGS: A total of 211 (2.6%) conscripts were granted a disability pension during the follow-up period between 1970 and 1991, and another 373 (4.6%) conscripts had high sickness absence (at least 180 sick days between 1989 and 1991). A total of 642 men had one or more DWI offences from the time of conscription until 1992. The median number of sick-days/sick-listed between 1989 and 1991 was 35.0 for men who were problem drinkers at conscription, 60.3 for drink drivers, 31.0 for men with less serious and 53.0 for men with serious crimes, compared to 21.0 days for the group as whole. In bivariate regression analysis, drink driving implied a relative risk (RR) of a disability pension/high sickness absence of 3.4 (95% CI: 2.8-4.1), and criminality a RR of 3.6 (95% CI: 3.1-4.1). In multivariate logistic regression analysis, controlling for psychosocial factors from conscription and for criminality, drink driving remained a strong predictor (RR 2.1, 95% CI: 1.7-2.7). CONCLUSIONS: Problem drinking, drink driving and criminality are important risk factors for receipt of disability pension and high levels of sickness absence in young men. The findings suggest that preventive efforts undertaken at the time of conscription and during later military service may pay dividends in term of preventing problems later in life.

Adolescent↗
PubMed2005

[Transfer of research findings into the practice of rehabilitation and effects on the development and stabilization of the infrastructure of rehabilitation sciences--the pension insurance perspective].

The programme for research in rehabilitation has been established by the Federal Ministry of Education and Research and the German Pension Insurance scheme in 1998 to further develop the methodology in this field. In addition to other effects, the large number of projects has strengthened the research structure in Germany. An important aim of the programme is the transfer of the research findings into the practice of rehabilitation. The initiators also organize this transformation process in terms of a long-term task. The paper describes the transfer of findings in the topics selected by the Pension Insurance scheme: patient education, access to rehabilitation, and vocational orientation in medical rehabilitation. Furthermore, additional activities concerning the transfer are outlined. To improve the practice of rehabilitation by transferring research findings is of great importance for the Pension Insurance scheme.

Biomedical Research↗
PubMed2006

[Predicting gainful employment in a population sample of 4225 statutory pension insurance members covering a prognostic period of five years using a brief subjective prognostic employment scale (SPE Scale)].

PURPOSE: Vocational (dis-)ability is a key concept in social medicine. It plays a major role in the realm of statutory pension funds (e. g. appraisal of applications for early retirement) as well as in epidemiologic or rehabilitation research. In a former population-based survey reliability of a short scale assessing the subjective prognosis of gainful employment (SPE-Scale, range = 0 - 3) had been tested. We now wanted to explore whether the SPE-Scale allows a prediction of vocational outcomes (early retirement) in the population sample over longer periods of time. METHODS: Statutory pension insurees from Luebeck and surroundings aged between 40 and 55 were surveyed by questionnaire in 1999/2000. For 4225 subjects (= 95% of the original cohort) we obtained the following outcome data from pension fund records: dates of any applications for early retirement and beginning of retirement, date of death. The follow-up period covers 4.75 years on average. During this period 323 applications for early retirement (= 7.6%) were filed, and 200 subjects (= 4.7%) actually retired. RESULTS: First analysis including age and sex as covariates showed a threefold (SPE = 2) and eightfold (SPE = 3) risk of early retirement. Multivariate analysis (covariates: overall health status, number of chronic conditions, approved disability, subjective vocational ability, and length of sick leave measured at study onset) yielded a twofold risk of filing an application for early retirement (SPE = 3). CONCLUSIONS: The SPE-Scale is an appropriate screening instrument for hazards regarding gainful employment. It also can be recommended for use in epidemiologic or rehabilitation surveys.

Adult↗
PubMed1983

Abusers of alcohol immediately prior to pension.

In the granting of a disability pension to an alcohol abuser society is taking a somewhat controversial step. In order to elucidate the overall situation of these abusers, the quality of life of 61 abusing applicants was examined. The sample represents all 78 first-time applicants during an 18-month period in a geographically defined region in the county of Ostergötland in Sweden. As expected, apart from their extensive abuse, the applicants were in bad psychiatric-psychological condition and demonstrated severe neuro-psychological and biochemical disturbances. In addition, their social network was somewhat restricted and also otherwise rather problematic. These deviations were evident in relation to a matched group of newly pensioned non-abusers. In comparison with another more closely matched group of abusers undergoing rehabilitation, the differences appeared mainly within the psychiatric-psychological sphere. This is a report in a series from the research project "Abuse of alcohol - Disability pension - Quality of life".

Alcohol Drinking↗
PubMed2005

Organisational downsizing as a predictor of disability pension: the 10-town prospective cohort study.

OBJECTIVE: To examine whether downsizing, the reduction of personnel in organisations, is a predictor of increased risk of disability retirement among employees who kept their jobs. DESIGN: Prospective cohort study. Based on reductions of personnel in participants' occupation and workplace, employees were grouped into exposure categories of no downsizing (less than 8% reduction), minor downsizing (reduction between 8% and 18%), and major downsizing (more than 18% reduction). They were followed up for a five year period after downsizing. SETTING: Four towns in Finland. PARTICIPANTS: 19 273 municipal employees, aged 21-54 years. MAIN OUTCOME MEASURES: All permanent full disability pensions granted because of medical reasons below 55 years of age between 1 January 1994 and 31 December 1998 from the national registers. RESULTS: In all, 223 employees were granted a permanent disability pension. The overall rate for disability pensions per 1000 employees was 7.7 after no downsizing, 13.1 after minor downsizing, and 14.9 after major downsizing. Cox proportional hazard models adjusted for age, sex, occupational status, type of employment contract, and town showed 1.81 (95% confidence intervals 1.22 to 2.70) times higher risk of disability retirement after major downsizing than after no downsizing. CONCLUSIONS: The immediate financial advantages of downsizing need to be considered in relation to increased occupational disability and the resulting extra costs to employers and society.

Adult↗
PubMed1980

Morbidity related to smoking and other risk factors. A population study of disability pension, hospital care and sickness benefit days among middle-aged men in Malmö, Sweden.

In 1969 a cohort of 703 men born in 1914 was screened to determine the prevalence of cardivascular and pulmonary diseases among middle-aged men. Smoking habits and other cardiovascular risk factors were registered. Hypertension was treated. The disability pension rate among non-smokers was considerably lower than that for smokers. Also the proportion of individuals who had been admitted to hospital and the proportion of individuals who had reported sick was lower in non-smokers than in smokers. The ex-smokers showed an intermediate position both in terms of disability pension rate and in proportion of individuals admitted to hospital. High systolic blood pressure, high cholesterol level and high triglyceride values in 1969 were not associated with increased disability pension rate, hospitalization rate or with increased sick leave.

Cardiovascular Diseases↗