Association of leisure-time physical activity at different phases of life with work ability at the end of working life: a Finland-representative 45-year prospective cohort study

OBJECTIVE: Leisure-time physical activity (LTPA) has been linked to better work ability in cross-sectional and short-term follow-up studies. Less is known about the effects of long-term habitual LTPA on work ability. We investigated whether differences in lifetime LTPA from adolescence to late adulthood affect work ability at the end of working life. METHODS: In this 45-year observational cohort study involving a nationally representative Finnish sample, we created a latent lifetime LTPA factor from three self-report PA measurements at ages 10-19, 35-44 and 55-64 years. The association between the lifetime LTPA factor and validated Work Ability Index at the end of working life (age 55-64 years) was explored with structural equation modelling-based linear regression analysis. RESULTS: Higher lifetime LTPA was associated with higher work ability at the end of working life (N=2385, 45% males; ß=0.22, SE=0.05, p<0.001) while all three LTPA measurements contributed to the latent LTPA factor (adolescence ß=0.29, SE=0.05; mid-adulthood ß=0.40, SE=0.06; late adulthood LTPA ß=0.59, SE=0.09). In late adulthood (N=815), meeting the 2020 WHO PA guidelines was dose-responsively associated with excellent work ability: OR very active (>2.38 metabolic equivalent of task (MET)-hour/day (>300 min moderate-to-vigorous PA (MVPA) or >150 min vigorous PA (VPA)/week) vs inactive (<1.19 MET-hour/day (<150 min MVPA or <75 min of VPA/week)) = 2.18, 95% CI 1.44 to 3.30; OR active (1.19-2.38 MET-hour/day (150-300 min MVPA or 75-150 min VPA/week)) vs inactive=1.67, 95% CI 1.04 to 2.68. The results remained unchanged after adjustment for covariates sex, educational level and work-related physical strain. CONCLUSIONS: An inactive lifestyle adopted in youth and maintained throughout life may present a significant risk for impaired work ability up to the end of working life. To support workforce productivity, it is essential to implement robust strategies that promote PA, particularly among children and adolescents, but also among working age adults.