Association of early labor market exit with mental disorders: a population-based cohort study in Taiwan

Early labor market exit is common in Taiwan, yet its long-term mental health consequences are not well understood.

This study examined the association between early labor market exit and the incidence of mental disorders, and explored the moderating effects of sociodemographic and physical health factors.

Using Taiwan's National Health Insurance Research Database (2011-2021), we identified 1,195,611 individuals aged 45-64 who exited the labor market early and 1,227,084 continuously employed counterparts. Incidence rates of dementia, depressive disorders, anxiety disorders, sleep disorders, and alcohol use disorders were assessed. Lag-time exclusions of one, three, and five years were applied to minimize reverse causation.

Early labor market exit was associated with higher risks of dementia (adjusted hazard ratio [aHR] = 1.04, 95% CI = 1.01-1.07) and alcohol use disorders (aHR = 1.16, 95% CI = 1.11-1.22). Associations with depressive, anxiety, and sleep disorders were weak or nonsignificant. The strength of associations varied by sex, occupation, and physical health status.

Early labor market exit increases the risk of dementia and alcohol use disorder. Preventive strategies promoting cognitive engagement, social participation, and healthy lifestyles may help reduce mental health risks among individuals leaving the workforce prematurely.