The risk for depression following retirement is higher in individuals who retire later in life, according to study findings published in The American Journal of Geriatric Psychiatry. Women and individuals living in rural areas seem particularly impacted.
Thus far, most studies exploring retirement age and depression have been primarily conducted in Northern European countries with social welfare systems that provide significant support for pensions and employment, contributing to better mental health after retirement. Taiwan (with low labor force participation rates, long working hours, stressful working conditions, and the fastest current rate of population aging globally) is trending toward delayed statutory retirement age and prolonged working life, and the impact this environment may have on later-in-life depression has not been thoroughly explored. Therefore, investigators in Taiwan aimed to determine if retirement is associated with depressive disorders and if retirement age is a mitigating factor.
The investigators conducted a population-based study using Taiwan’s National Health Insurance (NHI) dataset from January 2000 to December 2019. The NHI program in Taiwan enrolls about 99% of the national population and the dataset includes 2 million citizens determined by randomized sampling.
The investigators identified 84,224 individuals who were aged 50 years and older, employed at the baseline, and had records of retirement during the follow-up period. The International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to track the incidence of depressive disorders in the 7 years before and after retirement.
"Instead of implying a beneficial mental effect of retirement, our results highlight that retirement represents a major life change and a potential stressor for older adults."
The investigators found that age of retirement was oldest among those who had depression incidence before retirement (n=5111; 6.1%) and youngest among those with depression incidence after retirement (n=5222; 6.2%). For the subsequent analyses, participants with diagnosed depressive disorders prior to retirement were excluded.
The investigators found the highest incidence of depressive disorders among individuals who retired after 69 years of age (8.15 per 1000 person-years) and those who retired between 65 and 69 years of age (7.6 per 1000 person-years). This risk of developing a depressive disorder was higher among individuals retiring in the 65 to 69 age group compared with the 60 to 64 group (adjusted hazard ratio [aHR], 1.10; 95% CI, 1.02-1.18). Furthermore, the risk for depression was higher among women (aHR, 1.56; 95% CI, 1.47-1.65; P <.001), people living in rural areas (aHR, 1.11; 95% CI, 1.02-1.20; P =.015), and individuals with a Charlson Comorbidity Index of 1 (aHR, 1.40; 95% CI, 1.27-1.54; P <.001) or 2 and greater (aHR, 1.40; 95% CI, 1.28-1.52; P <.001).
These study results indicate that retiring at a later age carries a higher risk of developing depression. The investigators concluded, “Instead of implying a beneficial mental effect of retirement, our results highlight that retirement represents a major life change and a potential stressor for older adults.”
Study limitations include the use of insurance identities as proxy for retirement information, a lack of some demographic features, and an inability to identify individuals who may have depression but were not seeking medical help.
Yang HJ, Cheng Y, Yu TS, Cheng WJ. Association between retirement age and incidence of depressive disorders: a 19-year population-based study. Am J Geriatr Psychiatry. Published online September 16, 2023. doi:10.1016/j.jagp.2023.09.010