A meta-analysis of risk factors for disability retirement in middle-aged workers

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Abstract
Aims: This systematic review and meta-analysis aimed to identify sociodemographic, lifestyle, and occupational risk factors for disability retirement among middle-aged workers. Methods: Searches were conducted in PubMed, Web of Science, PsychInfo, Scopus, and Google Scholar from their inception until February 2025. Observational longitudinal studies involving workers aged 40–64 years were included. Two reviewers independently assessed the methodological quality of the studies. A random-effects meta-analysis was performed, with heterogeneity and publication bias evaluated. Results: From 13,899 reports, 71 reports from 39 longitudinal studies ( N =7,309,799 participants) were included. The meta-analysis found that older workers, women, those with 12 years or less education, and workers in intermediate or low occupational class are at increased risk of all-cause disability retirement. Other high-risk groups include past (hazard ratio (HR) 1.08, 95% confidence interval (CI) 1.01–1.15) and current (HR 1.29, 95% CI 1.17–1.41) smokers, individuals who are underweight (HR 1.49, 95% CI 1.00–2.23) or obese (HR 1.54, 95% CI 1.31–1.81), individuals lacking physical activity (HR 1.46, 95% CI 1.04–2.06), and those who consume excessive amounts of alcoholic drinks (HR 1.43, 95% CI 1.18–1.73). Additionally, high workload (HR 1.38, 95% CI 1.23–1.56) and low job control (HR 1.47, 95% CI 1.32–1.63) also contribute to the increased risk. Conclusions: This meta-analysis highlights the significant impact of being vulnerable groups, lifestyle risk factors, and physical and psychosocial work factors on the risk of disability retirement among middle-aged workers. Targeted interventions to create a supportive work environment and encourage healthy lifestyles are crucial to mitigating the risk of disability retirement.

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