Associations of health symptoms and conditions with disability retirement in middle-aged workers: a systematic review and meta-analysis

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Abstract Aim This systematic review and meta-analysis assessed the associations of health symptoms and conditions and their consequences with disability retirement among middle-aged workers. Methods Searches were conducted in PubMed, Web of Science, PsychInfo, and Scopus 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, 68 reports from 34 longitudinal studies ( N = 3,743,192 participants) were included. The meta-analysis found that health symptoms, including long sleep (≥ 8.5 h, hazard ratio [HR] 1.79, 95% CI 1.35–2.37), insomnia (HR 1.45, CI 1.29–1.64), and pain (HR 2.09, CI 1.40–3.11), health conditions, including mental health conditions (HR 2.19, CI 1.78–2.70), musculoskeletal disorders (HR 2.13, CI 1.25–3.64), diabetes (HR 1.55, CI 1.02–2.34), hypertension (HR 1.25, CI 1.05–1.50), cardiovascular disease (HR 1.98, CI 1.59–2.47), respiratory disease (HR 1.60, CI 1.12–2.29), and limiting long-standing illnesses (HR 4.81, CI 2.05–11.30), and health consequences, including impaired perceived work ability (HR 6.21, CI 2.93–13.15), suboptimal self-rated general health (HR 3.28, CI 2.36–4.56), and daily activity limitations (HR 6.29, CI 3.74–10.57) contribute to the increased risk of all-cause disability retirement. Interactions between different comorbidities were additive. Conclusions This meta-analysis highlights the significant impact of sleep problems, mental health conditions, various chronic diseases, and impaired work ability on the risk of disability retirement among middle-aged workers. Targeted interventions to promote sleep management and health conditions, particularly mental health, are crucial to mitigating the risk of disability retirement.

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