The sustainability of the labor market for older workers has become a central issue. The prolonged participation of these workers raises concerns for organizations, which face an increase in age-related chronic conditions and disabilities, leading to higher absenteeism rates and reduced work ability. Understanding the work ability of older workers is essential for society's sustainable development.

To identify the factors associated with work ability in older workers and whether they predict whether they will continue to participate in the workforce.

This is a systematic review of prospective cohort studies. The search was conducted between May and July 2024 in the following databases: PubMed, CINAHL, EMBASE, and Scopus. Only prospective cohort studies were included, with workers over 45 years of age and that had as an outcome an indicator of work ability and associated factors that should be able to predict whether to be involved in work (this includes retirement, total or partial disability pension). Studies with unemployed workers, which did not discriminate between age groups in the results and did not predict the ability to work and participate in work and continue working, were excluded. The methodological quality of the studies was assessed using the Newcastle-Ottawa Scale tool, a version for cohort studies.

1,063 studies published between 1969 and 2024 remained for the review of titles and abstracts. After reading the remaining 39 articles in full, 33 were excluded based on eligibility criteria, leaving six studies that passed the quality assessment process, of which five were classified as good quality and only one as poor quality. Work ability is a key predictor of prolonged absences and early retirement, influenced by older age, obesity, smoking, strenuous physical conditions, and compromised mental health. Depression and intense physical and emotional demands were associated with low mental and physical work ability over time. Factors such as temporary employment, low job satisfaction, and lack of investment in training increased the risk of dismissal. In addition, support and control in the workplace decreased the risks of early retirement and dissatisfaction.

Low work ability, other indicators of illness, heavy workload, dissatisfaction with life and work, employability, and inadequate training may influence whether workers continue to participate in the workforce.

This systematic review expands understanding of the interaction between individual health and the work environment across the career path, suggesting that modifiable factors such as control and support at work, in addition to reducing risk behaviors, can prevent absences and prolong healthy employment. The results indicate the importance of tailored workplace health promotion programs, including interventions focused on reducing smoking and weight control and measures that increase psychological support. The results obtained in this systematic review support managers, companies, and governments in improving working conditions, indicating the need for work planning, adequate training, and strategies to remain in work.