BMJ open · 2026
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.
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Park Su-Min, Ko Ah Jung, Joo Min Jeong, Park Eun-Cheol
Аннотация
OBJECTIVE: Frailty, 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.
DESIGN: A longitudinal study.
SETTING: A nationwide community-based longitudinal study using data from the Korean Longitudinal Study of Aging from 2006 to 2022.
PARTICIPANTS: Individuals 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.
RESULTS: The 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).
CONCLUSIONS: Returning 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.
DESIGN: A longitudinal study.
SETTING: A nationwide community-based longitudinal study using data from the Korean Longitudinal Study of Aging from 2006 to 2022.
PARTICIPANTS: Individuals 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.
RESULTS: The 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).
CONCLUSIONS: Returning 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.