Karin Borg

Predictive factors for disability pension — An 11-year follow up of young persons on sick leave due to neck, shoulder, or back diagnoses:

AIMS Although back diagnoses are recurrent and the main diagnoses behind sickness absence and disability pension surprisingly few longitudinal studies have been performed. This study identifies predictive factors for disability pension among young persons initially sick-listed with back diagnoses. METHODS An 11-year prospective cohort study was conducted, including all individuals in a Swedish city who, in 1985, were aged 25-34 and sick-listed > or =28 days owing to neck, shoulder, or back diagnoses (n = 213). The following data was obtained: disability pension, emigration, and death for 1985-96, sickness absence for 1982-84, and demographics in 1985 regarding sex, income, occupation, marital status, diagnosis, socioeconomic group, and citizenship. Cox regression and life tables were used in the analyses. RESULTS In 1996, i.e. within 11 years, 22% of the individuals (27% of the women and 14% of the men) had been granted disability pension. The relative risk for disability pension was higher for women (2.4; p = 0.010), persons with foreign citizenship (3.6; p=0.009), and those who had had >14 sick-leave days per spell during the three years before inclusion, compared to those with <7 days/spell (3.1; p=0.003). CONCLUSIONS This cohort of young persons proved to be a high-risk group for disability pension. Some of the factors known to predict long-time sickness absence also predict disability pension in a cohort of already sick-listed persons.

Risk factors for disability pension over 11 years in a cohort of young persons initially sick-listed with low back, neck, or shoulder diagnoses.

Aim: A study was undertaken to ascertain whether the differences in risk in relation to gender and citizenship observed in a previous study of the same cohort would remain if more recent data on sickness absence were used. Methods: This was an 11-year prospective population-based cohort study. The dataset includes all individuals in a Swedish city who, in 1985, were aged 25 - 34 and had a sick-leave spell≥28 days with neck, shoulder, or back diagnoses (n=213). The data covered the following: for 1985 - 96, disability pension, emigration, and death; for 1982 - 96, sickness absence; for 1985, sex and citizenship. The data were subjected to Cox regression analyses with a time-dependent covariate. Results: Disability pension was granted to 22% (n=46) of the cohort. The relative risk for disability pension increased by 9.3 with each sick-leave spell≥90 days during the two previous years. The risk was higher for women than men, and also higher for foreign citizens than Swedes. Conclusion: Many studies have revealed a gender difference in the risk of being on disability pension, and it was found that this difference was still apparent when sick leave during the follow-up period is taken into account. Thus, the reason for the gender differences ought to be found among other factors than prior levels of sickness absence.