ArticleBMJ open2026
Association between changes in working status and frailty across different types of employment: a longitudinal study in Korea, the world's most rapidly ageing nation.
Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveFrailty, a critical health indicator of ageing, poses significant public health challenges for individuals and society. This study analysed the longitudinal association between changes in employment status and frailty among middle-aged and older adults in Korea across different employment types. It also examined how employment transitions impact frailty components, particularly weakness, isolation and exhaustion.
designA longitudinal study.
settingA nationwide community-based longitudinal study using data from the Korean Longitudinal Study of Aging from 2006 to 2022.
participantsIndividuals aged 45 years or older residing in private households across Korea (excluding Jeju Island) enrolled in Wave 1 (2006). For consistency, only participants with at least four observations during the entire study period were retained. Those with fewer than four observations (n=48 228) were excluded, amounting to a final of 6122 participants, of whom 2718 were men and 3404 were women. Furthermore, for the subgroup analysis of employment types, participants not classified as regular, temporary, daily, self-employed or unpaid family workers were excluded. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was frailty assessed using the Korean Frailty Instrument. Secondary outcomes were the individual frailty components, including weakness, isolation and exhaustion.
resultsThe study included 6122 participants (2718 men and 3404 women). Frailty was observed in 3.9% of men and 8.5% of women. Returning to or maintaining employment was significantly associated with reduced frailty risk between both genders (male: Unemployed → Working OR 0.61, Working → Working OR 0.59; female: Unemployed → Working OR 0.68, Working → Working OR 0.77). Employment type-based analysis revealed that transitioning to permanent employment has the strongest protective effect on men (Unemployed → Permanent Employment OR 0.25).
conclusionsReturning to or maintaining employment was associated with a lower risk of frailty. Promoting stable employment environments and encouraging labour force participation among middle-aged and older adults may contribute to better health outcomes in ageing societies.
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