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Longitudinal Associations Between Core Health Domains, Assessed Using the PROMIS-29, and Work Ability in a Working Population: Findings from the Lifelines Cohort Study

Objective: To investigate the longitudinal relationship between core health domains, assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS-2)9, and work ability, and explore how this relationship differs for physical and mental work ability.

Methods: Data representing 22,608 workers were obtained from two waves of the Lifelines Cohort Study, a large population-based cohort in the Netherlands. Eight health domains, assessed at baseline using PROMIS-29 v2.1, were analyzed in relation to work ability, assessed at follow-up with single WAI items. Ordinal logistic regression analysis was used to model these relationships, adjusting for age, BMI, leisure-time physical activity, and follow-up time, and evaluating effect modification by gender.

Results: All PROMIS health domains were significantly associated with work ability at 4.6 years follow-up. Health domains reflecting worse health, e.g., fatigue, showed an inverse association with work ability (OR: 0.75, CI: 0.72-0.78), whereas domains reflecting better health, e.g., ability to participate in social roles and activities, showed positive associations (OR: 1.28, CI: 1.23-1.34). Some health domains, like physical function (OR: 1,35 CI: 1.26-1.45) and pain interference (OR: 0.84, CI: 0.78-0.91) were associated with physical work ability only, whereas anxiety, depression, fatigue, sleep disturbance, ability to participate in social roles and activities, and pain intensity were associated with both physical and mental work ability.

Conclusion: Health domains, assessed using the PROMIS-29, are longitudinally associated with general, physical and mental work ability. PROMIS-29 might be used to identify workers at risk of reduced work ability and potential sickness absence. Further research is needed to verify this and should directly examine the relationship between PROMIS-29 scores and objective sickness absence rates.

Keywords: Lifelines; Patient-reported measurement information system; Sickness absence; Work ability index.

Year of publication

2026

Journal

Journal of occupational rehabilitation

Author(s)

Toben, D.
de Wind, A.
Roorda, L.D.
Anema, J.

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