The mental health-related variables that were explored among the elderly in this study were divided into stress perception, psychiatric diagnosis of depression, and presence of suicidal ideation. Interestingly, they demonstrated different trends in being influenced by retired status. The observation that there were lower levels of stress perception among both men and women after retirement can be interpreted as the participants having previously been in stressful occupational and/or social environments that they no longer experienced. Furthermore, despite the lack of data as a limitation, retired status generally had a negative influence on the incidence of depressive symptoms and the presence of suicidal ideation.
The results of this study were not too far removed from those of the majority of previous studies with similar objectives. One such study found retirement to have a negative influence on mental health and morale [8], and another study reported that suicide rates were higher after retirement [9].
A major factor that impairs the mental health of the elderly post-retirement is retirement stress, which can be explained using the social stress model [10]. According to the model, retirement stress includes the feeling of loss due to reduced income, changes to daily life, deterioration of status both at home and in society, loss of self-identity, changes to one’s social network, reduction of meaningful life experiences, and negative attitudes towards retirement [11].
Depression is one of the most common mental health symptoms that the elderly experience due to maladaptation to retirement stress. A study that analyzed the relationship between retirement and depression among the retired elderly found that retirement led to declines in mental health and expected that lower retirement satisfaction could lead to depressive symptoms [12]. Furthermore, another study reported that retired individuals experienced higher incidence rates of various mental illnesses, including depression, compared to those who are employed [13].
We found that changes to the physical and psychological environment due to retirement influence mental health and influence the occurrence of chronic diseases. Behncke et al. [14] utilized data from the English Longitudinal Study of Ageing to analyze the various effects of retirement on health results using non-parametric matching and tool variables (IV), concluding that retirement increases the risk of chronic condition diagnosis by 10%. Particularly, they reported that retirement raises the risks of cardiovascular disease (4%) and cancer (3–4%) diagnoses, and that it was likely to cause issues in physical activity. Furthermore, a study by Alvinia found that leaving the labor market has a negative influence on chronic disease occurrence in many European countries [15].
In addition to yielding cross-sectional results, this study aimed to discover the most influential factors among multiple covariates that were impactful on the influence of retired status on elderly mental health. Among numerous results that can be found in Table 5, some notable points included that alcohol consumption was the most influential covariate among men, and that the sociodemographic block was the most influential among women.
Drinking in old age can lead to various geriatric physical conditions, and often causes psychiatric issues [16]. Experiencing a loss of social roles, reduced economic power, loneliness and alienation, and deaths of spouses after retirement leads to the experience of feelings such as helplessness, isolation, and self-blame; this may lead to new tendencies to drink or binge drink, or exacerbate existing problematic drinking [17]. Particularly, middle-aged men in Korean society may experience excessive stress and maladaptation to their post-retirement lives and are likely to engage in problematic drinking [18].
On the other hand, it is important to compare the retirement environment that women face when discussing the issue of retirement for elderly Korean women. Female Korean retirees comprise a generation that had to construct their own career paths while facing a lack of understanding regarding women’s employment due to the residue of patriarchal values; as such, they maintained their occupational status amidst social expectations and norms that differed from those for men, who were praised as work-oriented tendencies were equated with the responsibilities of the breadwinner [19]. Considering the particular cultural environment that Korean employed women faced, we are able to infer that the influence of sociodemographic factors will be significant.
There are two major points of views on elderly retirement. One point of view is viewing retirement as a crisis. In other words, retirement is regarded as a significant crisis faced during the later half of one’s life, resulting in a loss of status, a loss of self-identity, non-productive leisure time, and the social stigma of incompetence. On the other hand, the other point of view considers retirement to be a continuous phase of the life cycle. This viewpoint regards retirement as a predictable process, rather than a crisis that one abruptly faces. Furthermore, this viewpoint does not equate work with life, but instead regards it as a temporary task at a specific stage of life, asserting that retirement is not as significant a crisis as is commonly believed. Reviewing these two contrasting viewpoints in relation to the cultural characteristics of Korean society and mental health of the elderly, we are able to conclude that in Korea, retirement is likely to be perceived as a stressful event for the individual instead of as a simple change in environment. This is due to factors such as a comparatively younger retirement age, a lack of preparation for retirement, involuntary retirement, and weak social safety nets; furthermore, it can also be predicted that post-retirement adaptation will be relatively difficult [20].
However, not everyone who retires experiences declines in mental health. Jokela et al. [21] asserts that retirement has a positive influence on mental health, and that legal retirement and early voluntary retirement improve health status and physical functions. In a similar context, Charles et al. [22] found that freedom from labor via retirement has a positive influence on life satisfaction.
These differences can be attributed to individual vulnerabilities; although the retirees experience stress from retirement, an environmental event, the possibility of experiencing deteriorated mental health changes depending on the individual’s level of vulnerability. This can be explained using the stress-vulnerability model. The stress-vulnerability model is useful in understanding the causes and processes inducing mental illnesses through the interaction between individual vulnerability and environmental stress [23], and existing studies [24, 25] have attempted to approach elderly mental health issues through this model.
The main advantages of the present study are as follows. First, the health-related survey used in this study was conducted by trained professionals using a national sample of Koreans in a systematic manner. This study is valuable as it is the first study to comprehensively evaluate the effect of retirement on the mental health status of elderly Koreans on a national level. Another advantage is that we went beyond exploring cross-sectional association by adjusting factors that could act as confounding variables in the association between retired status and mental health variables to explore the level of influence of such factors on retirement and mental health levels.
However, this study also has the following limitations. First, given the cross-sectional study design, which limits the study to a short and specific period of time, this study can only derive associations rather than causal relationships.
Another limitation of this study is that the response data reflecting the mental health status of the elderly, such as levels of perceived stress and presence of suicidal ideation, were self-reported. This is a limitation because self-report surveys can lead to subjective and biased results, which differ from physicians’ diagnoses or diagnostic testing results. Furthermore, these self-report surveys carry the risk of being exposed to memory bias.
Lastly, a clear limitation of this study is the failure to obtain sufficient data for certain factors, which may have led to these factor acting as confounding variables in the regression analysis despite the fact that this study was carried out based on the results of a national survey. First, when analyzing health-related behaviors, we were not able to reflect the elderly female smoker population as there were no smokers among the studied female retirees. Furthermore, when examining the presence of suicidal ideation as one of the mental health variables, we were not able to examine this factor among men due to a small sample size. Although we were able to obtain an OR value of 3.2 across both genders, it would be difficult to compare gender-specific differences for this factor.