Life course epidemiology to inform preventive strategies for healthy ageing - Trajectories of well-being and behavioural risk factors across the transition to retirement

Retirement represents a major transition in the adult life course, often marking the cessation of occupational engagement and the onset of a phase characterised by altered routines, evolving social roles, and changes in health-related behaviours. As life expectancy increases and post-retirement life spans extend, understanding how retirement influences trajectories of health and well-being has become a priority for public health research. A multidimensional approach was adopted to examine how retirement affects mental health, lifestyle behaviours, and social participation, drawing on harmonised longitudinal data from European cohorts and context-specific surveys. Empirical evidence demonstrates that retirement can yield beneficial effects, particularly in the short term, including a reduction in depressive symptoms, a decline in smoking prevalence and intensity, and improvements in dietary quality and physical activity engagement. These positive changes are not uniformly distributed, as they are strongly moderated by factors such as socioeconomic status, voluntariness of retirement, pre-retirement occupational characteristics, and the broader social and environmental context. Notably, while daily alcohol consumption may increase modestly, it tends to become more regular and less associated with binge drinking, suggesting a nuanced behavioural adaptation rather than escalation. Beyond individual behaviours, the retirement transition also impacts social engagement, particularly in the form of grandparenting. While increased caregiving roles may enhance purpose and social connectedness, abrupt disruptions, such as those experienced during the COVID-19 pandemic, can exacerbate psychological distress. Moreover, gains in physical activity observed shortly after retirement often diminish over time, especially among individuals with lower socioeconomic resources or limited access to enabling environments. Methodologically, the application of longitudinal models and causal inference tools, such as Generalised Estimating Equations and Directed Acyclic Graphs, enables a more precise understanding of temporal dynamics and mediation pathways. This analytical framework reveals retirement as both a consequence and a determinant of health, necessitating careful adjustment for health-related selection into retirement. Overall, retirement emerges as a complex, heterogeneous, and context-dependent process that can either widen or mitigate health inequalities in later life. Targeted health promotion efforts, integrated within retirement transition policies, offer promising avenues to enhance population health and foster equitable, healthy ageing. Interventions should be tailored to the specific needs of vulnerable groups and coordinated across healthcare, social welfare, and community systems to ensure sustained well-being throughout the post-retirement years.