Effects of personal and work-related stressful life events on mental health among middle-aged and older Australians: longitudinal evidence from 16 waves of cohort data.

内容摘要

Stressful life events are recognised determinants of mental health, yet their effects in later life remain unclear. Reflecting increasing longevity, our study examined links between stressful life events, both personal and work-related, and mental health outcomes among middle-aged and older Australians aged 50 and over. We analysed 95 603 person-year observations from 11 187 individuals across 16 waves (2006-2021) of the nationally representative Household, Income and Labour Dynamics in Australia Survey. Key personal (eg, separation, physical violence, serious personal injury or illness, detention in jail) and work-related (eg, retirement, fired or made redundant, major worsening in finances) stressful life events were assessed. Mental health outcomes were assessed using the five-item Mental Health Inventory (MHI-5; range: 0-100) and the Mental Component Summary (MCS; range: -1.21-76.19), with lower scores indicating poorer mental health. Fixed-effects generalised least-squares models estimated within-individual changes, with stratification by age and gender. Personal and work-related stressful life events were consistently associated with poorer mental health outcomes. Separation (MHI-5: β = -3.790, 95% CI -5.235 to -2.345; MCS: β = -2.261, 95% CI -3.153 to -1.368), physical violence (MHI-5: β = -4.603, 95% CI -6.251 to -2.954; MCS: β = -2.562, 95% CI -3.601 to -1.523) and serious personal injury or illness (MHI-5: β = -3.620, 95% CI -4.916 to -2.323; MCS: β = -2.463, 95% CI -3.258 to -1.667) were associated with substantial reductions in mental health. Major worsening in finances produced the largest declines overall (MHI-5: β = -4.191, 95% CI -6.287 to -3.552; MCS: β = -2.714, 95% CI -3.561 to -1.867). Effect sizes varied across gender and age groups. Personal and work-related stressful life events adversely affect mental health among Australian middle-aged and older adults, highlighting the need for targeted policies, interventions and community support.