Employment in old age and all-cause mortality: A systematic review

Social participation promotes and maintains the health of older adults. Working is a type of social participation; however, the effect of employment in old age on health outcomes has not been established. This study aimed to review the relationship between employment in old age (>= 60 years) and all-cause mortality. For this systematic review, a computerized search was performed using PubMed, CINAHL and PsycINFO for prospective studies published through June 2020. The observational studies were extracted according to the study participants, indicators, follow-up period, statistical approach and main results. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Of the 37 832 records identified, 14 studies were included in the systematic review based on the inclusion and exclusion criteria. Eight studies were derived from Asian countries (four from Japan, two from Taiwan and one from Thailand and South Korea), three were from the United States, two were from Israel and one was from Brazil. The baseline data of 13 studies were collected before 2000. Thirteen of the 14 studies reported any association between employment in later life and a lower risk of mortality. Four studies examined the sex-related differences in the effect of later-life employment on all-cause mortality, but the association was controversial. Overall, we revealed that working in old age would lower mortality risk. Although more findings based on recent data are required, this study indicates that working later in life is beneficial for promoting and maintaining health.