Work frequency and subsequent health and well-being among older adults in Japan: An outcome-wide study

Background Working in later life has been linked to health and well-being, yet how work frequency relates to these outcomes remains uncertain. We examined associations between work frequency and subsequent multiple domains of health and well-being among older adults. Methods We used two datasets from the Japan Gerontological Evaluation Study (JAGES). Dataset 1 used three-wave panel data (2016, 2019, 2022; n = 41,758) for 42 self-reported outcomes. Dataset 2 linked 2016–2019 panel data to municipal long-term care insurance records through 2022 (n = 56,153), capturing mortality, dementia, and functional disability; together, analyses covered 46 indicators. Work frequency was categorized as not working, lower-frequency (1–3 times/month or several times/year), moderate-frequency (1–3 days/week), and higher-frequency (≥4 days/week) working. Models adjusted for 2016 covariates and prior outcome values. Results Moderate-frequency working showed favorable associations in 24 of 46 (52.2%) indicators. Higher-frequency working showed favorable associations in 25 of 46 (54.3%) indicators but was also associated with lower sports and hobby group participation and higher smoking and drinking prevalence (4 of 46, 8.7%). Both moderate- and higher-frequency working were associated with lower mortality (OR = 0.71 and 0.60; P for trend < 0.001). Analyses stratified by gender, age, education, and household income showed similar patterns, with limited effect modification. Conclusions Older adults who worked showed lower mortality and more favorable values on many indicators than those who did not, and differences varied by frequency. Interpretation requires caution: health shapes who keeps working, and work quality was unmeasured; both warrant further study.