[Longitudinal association between work and self-rated health in older adults: a systematic review]

Objective　Japan's shortage in labor force due to a declining birth rate and aging population has led to the rapid development of various systems and work environments to promote the employment of older adults. With increasing expectations for the active participation of older adults in the labor market, it is necessary to clarify the relationship between work and physical and mental health in this population, as well as the challenges they face. In particular, self-rated health is an important health indicator that captures the overall health status of older adults, which is strongly related to the decline in life functions and the increase in healthy life expectancy. In this study, we examined the longitudinal association between work and self-rated health perception among older adults.Methods　A literature search was conducted using PubMed, PsycINFO, CINAHL, and the Japana Centra Revuo Medicina (Igaku Chuo Zasshi in Japanese). The keywords selected for the search were "older adult," "employment," and "self-rated health." The inclusion criteria were i) the baseline age of study subjects was 60 years or older, ii) employment was used as an independent variable and self-rated health was used as a dependent variable, and iii) studies were longitudinal. The quality of the selected literature was assessed using the Newcastle-Ottawa Scale (NOS).Results　As a result of the review, a total of five studies were accepted. Four studies were from Japan and one was from the United States. The NOS scores showed that all selected studies were of high quality, scoring 6 or 7 on a 9-point scale. Three of the five studies reported that older adults who were working had higher self-rated health than those who were not working. Two of the five studies reported no significant association between employment and self-rated health among older adults.Conclusion　This systematic review suggested a significant relationship between work and self-rated health among older adults. However, the number of studies that focused on the longitudinal effect of employment was limited. Employment in later life is becoming increasingly common, therefore further evidence on its effect on health should be gathered.