Association of multimorbidity with working life expectancy among adults aged 50 years and older: Findings from two prospective cohort studies.

Background: Individual diseases are important risk factors for early exit from the labour force among older adults, but the contribution of multimorbidity to working life expectancy (WLE) is unclear. Methods: We used data from two prospective cohort studies: Finnish Public Sector study (FPS) and Health and Social Support Study (HeSSup). Multimorbidity at baseline was ascertained from a combination of self-reported, physician-diagnosed chronic diseases, and nationwide cancer and medication reimbursement registers. WLE from age 50 up to 68 years was ascertained utilising linked data from a nationwide register of pensionable earnings. WLE was estimated utilising a multi-state models in R. Results: Our findings were based on data from 56,079 women and 17,078 men aged ≥50 years. In FPS, women and men with two chronic diseases could expect to work about 9 months less and those with three or more chronic diseases could expect to work about a year less than those with no chronic disease. In HeSSup, women and men with three or more diseases had about 2-3 years shorter WLEs than those with no disease. In both studies participants with physical-mental multimorbidity had 3-12 months shorter WLEs and individuals with multimorbidity comprising two physical diseases had 8-10 months shorter WLEs than those with no chronic disease. The patterns were similar across the socioeconomic positions. Conclusion: Women and men with multiple chronic diseases could expect to work ∼1 year less than those with no chronic disease. The differences in WLE can have important economic implications to individuals, health services and society.