Socioeconomic and psychosocial adversity in midlife and depressive symptoms post retirement: a 21-year follow-up of the Whitehall II study.

ABSTRACT

OBJECTIVE: We examined whether socioeconomic and psychosocial adversity in midlife predicts post-retirement depressive symptoms. DESIGN AND SETTING: A prospective cohort study of British civil servants who responded to a self-administered questionnaire in middle-age and at older ages, 21 years later. PARTICIPANTS: The study sample consisted of 3,939 Whitehall II Study participants (2,789 men, 1,150 women; mean age 67.6 years at follow-up) who were employed at baseline and retired at follow-up. MEASUREMENTS Midlife adversity was assessed by self-reported socioeconomic adversity (low occupational position; poor standard of living) and psychosocial adversity (high job strain; few close relationships). Symptoms of depression post-retirement were measured by the Center for Epidemiologic Studies Depression scale. RESULTS: After adjustment for sociodemographic and health-related covariates at baseline and follow-up, there were strong associations between midlife adversities and post-retirement depressive symptoms low occupational position (odds ratio [OR] 1.70, 95% confidence interval [CI] 1.15-2.51), poor standard of living (OR 2.37, 95% CI 1.66-3.39), high job strain (OR 1.52, 95% CI 1.09-2.14), and few close relationships (OR 1.51, 95% CI 1.12-2.03). The strength of the associations between socioeconomic, psychosocial, work-related, or non-work related exposures and depressive symptoms was similar. CONCLUSIONS: Robust associations from observational data suggest that several socioeconomic and psychosocial risk factors for symptoms of depression post-retirement can be detected already in midlife.