Can psychosocial work conditions protect against age-related cognitive decline? Results from a systematic review

Is the mental health of older adults receiving care from their children related to their children's dual burden of caregiving and work stress? A linked lives perspective

OBJECTIVES

Mental health problems are a major concern in the older population in Sweden, as is the growing number of older adults aging alone in their homes and in need of informal care. Using a linked lives perspective, this study explored if older parents' mental health is related to their children's dual burden of informal caregiving and job strain.

METHODS

Data from a nationally representative Swedish survey, SWEOLD, were used. Mental health problems in older age (mean age 88) were measured with self-reported 'mild' or 'severe' anxiety and depressive symptoms. A primary caregiving adult child was linked to each older parent, and this child's occupation was matched with a job exposure matrix to assess job strain. Logistic regression analyses were conducted with an analytic sample of 334.

RESULTS

After adjusting for covariates, caregiving children's lower job control and greater job strain were each associated with mental health problems in their older parents (OR 2.52, p = 0.008 and OR 2.56, p = 0.044, respectively). No association was found between caregiving children's job demands and their older parents' mental health (OR 1.08, p = 0.799).

CONCLUSION

In line with the linked lives perspective, results highlight that the work-life balance of informal caregiving adult children may play a role in their older parent's mental health.

Life course engagement in enriching activities: When and how does it matter for cognitive aging?

Growing evidence suggests that participation in enriching activities (physical, social, and mental) across the life course is beneficial for cognitive functioning in older age. However, few studies have examined the effects of enrichment across the entire life course within the same participants. Using 2,931 participants in the Health and Retirement Study, we linked self-report data from later life and retrospective self-report data from early life and midlife to cognitive performance after Age 65. We categorized participants as having either high (top ∼25%) or average to low (bottom ∼75%) level of enrichment during each life period. Thus, eight groups were identified that reflected unique patterns of enrichment during early, mid, and later life (e.g., high-high-high). Using growth curve modeling, we found that life course enrichment patterns predicted both cognitive functioning and the rate of cognitive decline across five time points spanning 8 years (Aim 1). Groups with high enrichment during at least one life period had higher performance and slower decline in older age, compared to those who had average to low levels of enrichment throughout all three life periods. We also found that high enrichment during each life period independently predicted better cognitive performance and that high enrichment during early and later life also predicted slower cognitive decline (Aim 2). These findings support the idea that high enrichment is beneficial for cognition in later life and that the effects are long-lasting, even when individuals are inconsistent in enrichment engagement throughout the entire life course. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Social enrichment on the job: Complex work with people improves episodic memory, promotes brain reserve, and reduces the risk of dementia

Individuals with more complex jobs experience better cognitive function in old age and a lower risk of dementia, yet complexity has multiple dimensions. Drawing on the Social Networks in Alzheimer Disease study, we examine the association between occupational complexity and cognition in a sample of older adults (N = 355). A standard deviation (SD) increase in complex work with people is associated with a 9% to 12% reduction in the probability of mild cognitive impairment or dementia, a 0.14-0.19 SD increase in episodic memory, and a 0.18-0.25 SD increase in brain reserve, defined as the gap (residual) between global cognitive function and magnetic resonance imaging (MRI) indicators of brain atrophy. In contrast, complexity with data or things is rarely associated with cognitive outcomes. We discuss the clinical and methodological implications of these findings, including the need to complement data-centered activities (e.g., Sudoku puzzles) with person-centered interventions that increase social complexity.

Gendered life courses and cognitive functioning in later life: the role of context-specific gender norms and lifetime employment

With increasing life expectancy, dementia poses an epidemiological challenge. As a cure has not been developed, the investigation into preventive factors becomes pivotal. Previous research emphasizes the cognitively stimulating and socio-emotional benefits of lifetime employment, but research on heterogeneous patterns across social groups and societal contexts remains sparse. Sociological approaches have a promising potential to provide insights into health inequalities and can contribute to the study of this major societal challenge. We investigate the influence of previous employment biographies on cognitive functioning for men and women aged 50 to 75 in 19 European countries, using longitudinal and retrospective information from the Survey of Health, Ageing and Retirement in Europe. We link individual information on employment biographies and cognitive functioning to contextual measures of gender norms, using aggregated agreement rates to both men's and women's role in employment and family. We find that previous employment affects cognitive functioning men and women differently. Part-time employment is beneficial for women's cognitive functioning, but not for men's. Traditional gender norms are associated with lower levels of cognitive functioning for both genders and moderate the linkage between previous employment and cognitive functioning. In contexts with more traditional gender norms, men's part-time employment is associated with lower and women's part-time employment with higher cognitive functioning. We conclude that employment and non-employment participation can, depending on characteristics of individuals and contexts, benefit or hinder the life-course accumulation of cognitive reserve, and those with norm-deviating behaviour are disadvantaged.

Work-Related Psychosocial Factors and Global Cognitive Function: Are Telomere Length and Low-Grade Inflammation Potential Mediators of This Association?

The identification of modifiable factors that could maintain cognitive function is a public health priority. It is thought that some work-related psychosocial factors help developing cognitive reserve through high intellectual complexity. However, they also have well-known adverse health effects and are considered to be chronic psychosocial stressors. Indeed, these stressors could increase low-grade inflammation and promote oxidative stress associated with accelerated telomere shortening. Both low-grade inflammation and shorter telomeres have been associated with a cognitive decline. This study aimed to evaluate the total, direct, and indirect effects of work-related psychosocial factors on global cognitive function overall and by sex, through telomere length and an inflammatory index. A random sample of 2219 participants followed over 17 years was included in this study, with blood samples and data with cognitive function drawn from a longitudinal study of 9188 white-collar workers (51% female). Work-related psychosocial factors were evaluated according to the Demand-Control-Support and the Effort-Reward Imbalance (ERI) models. Global cognitive function was evaluated with the validated Montreal Cognitive Assessment (MoCA). Telomere length and inflammatory biomarkers were measured using standardised protocols. The direct and indirect effects were estimated using a novel mediation analysis method developed for multiple correlated mediators. Associations were observed between passive work or low job control, and shorter telomeres among females, and between low social support at work, ERI or iso-strain, and a higher inflammatory index among males. An association was observed with higher cognitive performance for longer telomeres, but not for the inflammatory index. Passive work overall, and low reward were associated with lower cognitive performance in males; whereas, high psychological demand in both males and females and high job strain in females were associated with a higher cognitive performance. However, none of these associations were mediated by telomere length or the inflammatory index. This study suggests that some work-related psychosocial factors could be associated with shorter telomeres and low-grade inflammation, but these associations do not explain the relationship between work-related psychosocial factors and global cognitive function. A better understanding of the biological pathways, by which these factors affect cognitive function, could guide future preventive strategies to maintain cognitive function and promote healthy aging.

Psychosocial working conditions and cognitive and physical impairment in older age

BACKGROUND

Psychosocial working conditions are associated with cognitive and physical impairments. The aim of this study was to investigate the associations between mid-late life psychosocial working conditions and the combination of physical and cognitive impairment among older adults, and the potential sex differences in these associations.

METHODS

Data were derived from two Swedish nationally representative surveys (n = 839; follow-up: 20-24 years). Multinomial and binary logistic regressions assessed the associations between work stressors (job demand-control model), and a combination of cognitive and physical impairment.

RESULTS

Low control jobs were significantly associated with higher odds of cognitive (OR: 1.41, CI: 1.15-1.72) and physical impairment (OR: 1.23, CI: 1.02-1.47), and cognitive and physical impairment combined (OR: 1.50, CI: 1.19-1.89). Passive jobs (low control, low demand) were associated with higher odds of cognitive impairment (OR: 1.57, CI: 1.12-2.20), and combined cognitive and physical impairment (OR: 1.59, CI: 1.07-2.36). Active jobs (high control, high demand) were associated with lower odds of cognitive impairment (OR: 0.48, CI: 0.29-0.80). Sex-stratified analyses showed stronger associations among men; passive jobs were associated with both cognitive (OR: 2.18, CI: 1.31-3.63) and physical impairment (OR: 1.78, CI: 1.13-2.81), while low strain jobs were associated with less physical impairment (OR: 0.55, CI: 0.33-0.89). No significant associations between work stressors and impairment were found for women.

CONCLUSIONS

These results highlight the importance of psychosocial working conditions for late-life physical and cognitive impairment, especially among men. Jobs characterised by low control and low demands are associated with higher risk for impairments.

Employment Characteristics and Risk of Hospitalization Among Older Adults Participating in the Mayo Clinic Biobank

Objective

To determine the relationship between characteristics of employment and future hospitalization in older adults.

Patients and Methods

We conducted a survey of adults aged 65 years or older participating in the Mayo Clinic Biobank. Using a frequency-matched, case-control design, we compared patients who were hospitalized within 5 years of biobank enrollment (cases) with those who were not hospitalized (controls). We assessed the duration of work, age at first job, number of jobs, disability, retirement, and reasons for leaving work. We performed logistic regression analysis to assess the association of these factors with hospitalization, accounting for age, sex, comorbid conditions, and education level.

Results

Among 3536 participants (1600 cases and 1936 controls; median age, 68.5 years; interquartile range, 63.4-73.9 years), cases were older, more likely to be male, and had lower education levels. Comorbid illnesses had the largest association with hospitalization (odds ratio [OR], 4.09; 95% CI, 3.37-4.97 [highest vs lowest quartile]). On adjusted analyses, odds of hospitalization increased with the presence of disability (OR, 1.31; 95% CI, 1.01-1.69) and decreased with having 1 or 2 lifetime jobs vs no employment (OR, 0.77; 95% CI, 0.60-1.00). The length of work, furlough, age of retirement, childcare issues, and reasons for leaving a job were not associated with hospitalization.

Conclusion

This study reports an association between disability during work and hospitalization. On the basis of our findings, it may be important to obtain a more detailed work history from patients because it may provide further insight into their future health.

Occupational cognitive stimulation, socioeconomic status, and cognitive functioning in young adulthood

BACKGROUND

Occupational characteristics are associated with late-life cognition. However, little is known about the association between occupational factors and cognition in early adulthood, especially when controlling for early life socioeconomic status (SES) and cognition in childhood. Importantly, sex may shape the impact of occupational characteristics that provide cognitive stimulation given that education, occupational status, and workplace experiences differ by sex.

METHODS

Using data on 12,129 participants ages 24-32 from the U.S.-based National Longitudinal Study of Adolescent to Adult Health, we investigated the association between four factors of occupational cognitive stimulation (repetition, freedom, analytic skills, and social interaction) and young-adult episodic and working memory independent of childhood and young-adult SES, using linear regression. We adjusted for confounding due to sex, race/ethnicity, age, childhood cognition, and education. We further investigated effect measure modification of this association by sex in stratified regression models.

RESULTS

Overall, 1-unit increases in both occupational analytic skills and social interaction were significantly associated with 0.101 (95%CI: 0.28, 0.173) and 0.096 (95%CI: 0.032, 0.160) SD higher memory, respectively. However, when sex-stratified, among men, a 1-unit increase on the social interaction scale was associated with 0.16 (95%CI: 0.05, 0.27) SD higher memory, while there was no association among women.

CONCLUSION

Our results indicate that even in adulthood, activities that stimulate the mind can contribute to improved cognitive function, and the most beneficial forms of occupational stimulation are those that use analytic skills and involve social interaction (particularly among young men).

Association of mental demands in the workplace with cognitive function in older adults at increased risk for dementia

Objectives

Growing evidence suggests a protective effect of high mental demands at work on cognitive function in later life. However, evidence on corresponding associations in older adults at increased risk for dementia is currently lacking. This study investigates the association between mental demands at work and cognitive functioning in the population of the AgeWell.de-trial.

Methods

Cross-sectional investigation of the association between global cognitive functioning (Montreal Cognitive Assessment) and mental demands at work in older individuals at increased risk for dementia (Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE)score ≥ 9; n = 941, age: 60–77 years). Occupational information was matched to Occupational Information Network (O*NET)-descriptors. Associations between cognitive function and O*NET-indices executive, verbal and novelty were investigated using generalized linear models.

Results

Higher values of index verbal (b = .69, p = .002) were associated with better cognitive function when adjusting for covariates. No association was observed for indices executive (b = .37, p = .062) and novelty (b = .45, p = .119). Higher education, younger age, and employment were linked to better cognitive function, while preexisting medical conditions did not change the associations. Higher levels of depressive symptomatology were associated with worse cognitive function.

Conclusions

Higher levels of verbal demands at work were associated with better cognitive function for older adults with increased dementia risk. This suggests an advantage for older persons in jobs with high mental demands even after retirement and despite prevalent risk factors. Longitudinal studies are warranted to confirm these results and evaluate the potential of workplaces to prevent cognitive decline through increased mental demands.

Working life job strain status and cognitive aging in Europe: A 12-year follow-up study

BACKGROUND

To examine the association of job strain with cognitive ability and the influence of life-course job strain on later life cognitive decline.

METHODS

Data were derived from six waves of the Survey of Health, Aging, and Retirement in Europe. The study sample consists of 13349 participants aged 50 to 98 years at wave 2 and has been followed up for 12-years. Job strain status across working life was assessed using a short demand-control job strain model containing two core dimensions: job demands and job control collected in wave 3. Cognitive abilities concerning episodic memory was assessed by immediate recall and delayed recall tests, executive function was evaluated by verbal fluency test collected in all waves (waves 2-7) except wave 3. Mixed-effects model was used to estimate working life job strain and its cumulative effect on cognitive decline.

RESULTS

Both passive and high strain jobs were associated with lower levels of cognitive ability (episodic memory and verbal fluency) in comparison with active job. Long exposure to active- or low strain-job was associated with higher cognitive ability whereas long exposure to passive job or moderate duration of high strain job was associated with lower cognitive ability. The rate of memory decline was positively related to moderate duration of passive job and negatively related to long-term exposure to low strain job.

LIMITATIONS

Information on working conditions was based on self-reported recollections.

CONCLUSIONS

Working life variation in job strain status and their duration may explain individual differences in cognitive ability in later life.

Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14)

Purpose

This study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated.

Methods

The study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively.

Results

Mean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r =  − 0.246, p = 0.003), work discontent (r =  − 0.299, p = 0.006) and pressure to succeed (r =  − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA.

Conclusions

Our study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00404-021-06289-z.

Psychosocial stressors at work and inflammatory biomarkers: PROspective Quebec Study on Work and Health

BACKGROUND

Chronic low-grade inflammation has been associated with high risk of several chronic diseases such as cardiovascular diseases, diabetes, depression, and dementia. As low-grade inflammation could be present long before the apparition of the disease, identifying modifiable risk factors could allow to act upstream. Psychosocial stressors at work have been suggested as modifiable risk factors of low-grade inflammation, but few longitudinal studies have evaluated the association between these stressors and inflammatory biomarkers, such as C-reactive protein (CRP) and interleukin-6 (IL-6).

OBJECTIVE

This longitudinal study evaluate the associations between exposure to psychosocial stressors at work and CRP and IL-6, separately and combined into an inflammatory index.

METHODS

Data came from a cohort of 9188 white-collar workers recruited in 1991-1993 (T1) and followed-up after 8 (T2, 1999-2000) and 24 (T3, 2015-2018) years. Participants included in this study were randomly selected at T3 for serum biomarkers studies (n = 2557). CRP and IL-6 were measured using standardized protocols. Psychosocial stressors at work were assessed at T2 according to recognized models: Karasek's Demand-Control-Support model and Siegrist's Effort-Reward Imbalance (ERI) model, using validated questionnaires. High job strain was defined by an exposure to high psychological demand combined with low job control, and iso-strain was defined by an exposure to high job strain combined with low social support at work. ERI was defined by an imbalance between psychological demand and social, economic, and organizational reward. Several covariates were considered including sociodemographic, anthropometric, and lifestyle characteristics, and comorbidities. Prevalence ratios (PRs) and 95% confidence interval (CI) for the highest quartile of CRP, IL-6 and inflammatory index at T3 according to psychosocial stressors at work measured at T2 were calculated using generalized estimating equations. Multiple imputation and inverse probability of censoring weighting were done.

RESULTS

In men, an association was observed between exposure to iso-strain and the inflammatory index (PR of 1.42 (95% CI: 1.06;1.90)), mainly among men aged less than 65 years (PR of 2.00 (95% CI: 1.37;2.92)). In this same age group, associations with inflammatory biomarkers were also observed among men with exposure to ERI, and among women with exposure to low reward at work or moderate social support at work.

CONCLUSION

These results suggest that psychosocial stressors at work may increase low-grade inflammation. However, further studies are needed to corroborate these results and to clarify the potential differences between men and women. As these stressors are frequent and modifiable, their reduction is important for public health and could play a role in the primary prevention of chronic diseases.

Organizational Justice and Cognitive Failures in Japanese Employees: A Cross-Sectional Study

OBJECTIVE

We examined the association of organizational justice (ie, procedural justice and interactional justice) with cognitive failures, and the mediation effect of psychological distress on this association in Japanese employees.

METHODS

A total of 189 men and 35 women from two sites of a manufacturing company in Japan were surveyed using a self-administered web-based questionnaire. A multiple mediation analysis was conducted.

RESULTS

A significant negative total effect of procedural justice on cognitive failures was observed (c = -0.180 [95% confidence interval: -0.315 to -0.044]). Furthermore, the mediation effect of psychological distress was significant (c-c' = -0.213 [95% confidence interval: -0.323 to -0.115]). Similar patterns were observed for interactional justice.

CONCLUSIONS

Employees may be more likely to experience cognitive failures in daily activities in work settings where organizational justice is lower, which seems to be explained by psychological distress.

Mentally Challenging Occupations Are Associated With More Rapid Cognitive Decline at Later Stages of Cognitive Aging

OBJECTIVES

Engaging in mentally challenging activities is associated with reduced risk for cognitive impairment and dementia; however, its association with rates of cognitive decline has been inconsistent. The aim of this study is to test whether working in mentally challenging occupations is related to rates of cognitive change at later older adulthood.

METHOD

The sample consisted of 1,520 individuals (baseline mean age = 78.6 ± 5.1, range = 64-100) from the Einstein Aging Study. Occupation information of each participant was collected retrospectively and linked with the substantive complexity of work score from the Dictionary of Occupational Titles. Cognitive changes in memory, speed, and executive function (EF) domains were represented using two time metrics (i.e., time from retirement, time from study enrollment).

RESULTS

Results from mixed models showed that occupational complexity was associated with significantly faster rates of cognitive decline in speed and EF in the "time from retirement" model but not in the "time from baseline" model. Despite faster cognitive loss, the protective effect of occupational complexity persisted for decades after retirement due to higher initial levels of cognition.

DISCUSSION

The result suggests that protective factors for cognitive health may be associated with delayed onset but more rapid cognitive decline afterwards at later stages of cognitive aging.

Impact of occupational complexity on cognitive decline in the oldest-old

OBJECTIVES

The theory of "Cognitive Reserve" assumes that premorbid factors such as high educational and occupational attainment may enable a better way of coping with brain damage. It has been suggested that more stimulating lifestyles, including more complex work environments, may provide a buffer against cognitive decline in later life. This study aimed to investigate the association between occupational history and cognitive decline in a large cohort of Italian oldest-old.

METHODS

392 individuals (266 women/126 men, mean age 93 ± 3 years) enrolled in the "Mugello study" provided information about their work history. Jobs were classified in nine categories, according to the level of expertise required to perform them, as suggested by the Italian National Institute for Statistics (ISTAT). In addition, socio-demographic characteristics, comorbidities, level of independence, depression, and cognitive status were assessed. The presence of dementia was established based on cognitive status and independence in performing four selected instrumental activities of daily living (ability to manage telephone, transportation, medications, and budget).

RESULTS

Neither work complexity (p = 0.995) nor work duration (p = 0.701) showed a significant effect on the likelihood of presenting a lower cognitive profile or developing dementia (p = 0.385 and p = 0.096, for work complexity and work duration, respectively).

CONCLUSION

In the observed sample of oldest-old individuals, cognitive decline did not seem to be influenced by cognitive reserve as assessed through the evaluation of cognitive status and level of independence. It is conceivable that in this population, the decline of the brain reserve has a preponderant role in the definition of the cognitive profile.

Job Strain and Trajectories of Cognitive Change Before and After Retirement

OBJECTIVES

We examined associations between job strain and trajectories of change in cognitive functioning (general cognitive ability plus verbal, spatial, memory, and speed domains) before and after retirement.

METHODS

Data on indicators of job strain, retirement age, and cognitive factors were available from 307 members of the Swedish Adoption/Twin Study of Aging. Participants were followed up for up to 27 years (mean = 15.4, SD = 8.5).

RESULTS

In growth curve analyses controlling for age, sex, education, depressive symptoms, cardiovascular health, and twinness, greater job strain was associated with general cognitive ability (estimate = -1.33, p = .002), worse memory (estimate = -1.22, p = .007), speed (estimate = -1.11, p = .012), and spatial ability (estimate = -0.96, p = .043) at retirement. Greater job strain was also associated with less improvement in general cognitive ability before retirement and a somewhat slower decline after retirement. The sex-stratified analyses showed that the smaller gains of general cognitive ability before retirement (estimate = -1.09, p = .005) were only observed in women. Domain-specific analyses revealed that greater job strain was associated with less improvement in spatial (estimate = -1.35, p = .010) and verbal (estimate = -0.64, p = .047) ability before retirement in women and a slower decline in memory after retirement in women (estimate = 0.85, p = .008) and men (estimate = 1.12, p = .013). Neither preretirement nor postretirement speed was affected significantly by job strain.

DISCUSSION

Greater job strain may have a negative influence on overall cognitive functioning prior to and at retirement, while interrupting exposure to job strain (postretirement) may slow the rate of cognitive aging. Reducing the level of stress at work should be seen as a potential target for intervention to improve cognitive aging outcomes.

Cumulative exposure to psychosocial stressors at work and global cognitive function: the PROspective Quebec Study on Work and Health

OBJECTIVES

Psychosocial stressors at work have been proposed as modifiable risk factors for mild cognitive impairment (MCI). This study aimed to evaluate the effect of cumulative exposure to psychosocial stressors at work on cognitive function.

METHODS

This study was conducted among 9188 white-collar workers recruited in 1991-1993 (T1), with follow-ups 8 (T2) and 24 years later (T3). After excluding death, losses to follow-up and retirees at T2, 5728 participants were included. Psychosocial stressors at work were measured according to the Karasek's questionnaire. Global cognitive function was measured with the Montreal Cognitive Assessment. Cumulative exposures to low psychological demand, low job control, passive job and high strain job were evaluated using marginal structural models including multiple imputation and inverse probability of censoring weighting.

RESULTS

In men, cumulative exposures (T1 and T2) to low psychological demand, low job control or passive job were associated with higher prevalences of more severe presentation of MCI (MSMCI) at T3 (Prevalence ratios (PRs) and 95% CIs of 1.50 (1.16 to 1.94); 1.38 (1.07 to 1.79) and 1.55 (1.20 to 2.00), respectively), but not with milder presentation of MCI. In women, only exposure to low psychological demand or passive job at T2 was associated with higher prevalences of MSMCI at T3 (PRs and 95% CI of 1.39 (0.97 to 1.99) and 1.29 (0.94 to 1.76), respectively).

CONCLUSIONS

These results support the deleterious effect of a low stimulating job on cognitive function and the cognitive reserve theory. Psychosocial stressors at work could be part of the effort for the primary prevention of cognitive decline.

Examining gender differentials in the association of low control work with cognitive performance in older workers

BACKGROUND

Limited workplace control, an important dimension of job strain, can reduce occupational opportunities for problem solving and learning. Women may have fewer professional resources to mitigate effects of low control, while conversely, gender-role norms may moderate the influence of occupational psychosocial risk factors. We therefore examined whether the links between control and cognitive function were similarly gendered.

METHODS

This observational, longitudinal study included respondents of the Survey of Health, Ageing and Retirement in Europe who were aged 50-64 years at entry, employed and provided at least two measurements of control and cognition (n = 6697). Relationships between control and cognition, quantified with standardized scores from verbal fluency, immediate and delayed word recall tests, were explored using linear fixed-effect and random-effect models with gender interactions.

RESULTS

Consistent trends of improved verbal fluency performance with high control were evident across analyses, equal to producing around three-quarters of a word more under high control conditions, with an effect size ∼0.1 SD units (fully adjusted models, range 0.077-0.104 SD), although associations with recall tests were inconsistent. We did not find evidence of clear gender differences in control-cognition relationships for any of the cognitive domains.

CONCLUSIONS

The cognitive health of older European workers may benefit from improved workplace control irrespective of gender. Possible sources of bias that could explain the lack of gender differences are discussed, particularly gender differences in labour force participation, response behaviour in job control ratings and implications of gender-role norms on the importance of occupational risk factors.

Life-course trajectories of working conditions and successful ageing

Aims:

As populations are ageing worldwide, it is important to identify strategies to promote successful ageing. We investigate how working conditions throughout working life are associated with successful ageing in later life.

Methods:

Data from two nationally representative longitudinal Swedish surveys were linked (n=674). In 1991, respondents were asked about their first occupation, occupations at ages 25, 30, 35, 40, 45 and 50 years and their last recorded occupation. Occupations were matched with job exposure matrices to measure working conditions at each of these time points. Random effects growth curve models were used to calculate intra-individual trajectories of working conditions. Successful ageing, operationalised using an index including social and leisure activity, cognitive and physical function and the absence of diseases, was measured at follow-up in 2014 (age 70 years and older). Multivariable ordered logistic regressions were used to assess the association between trajectories of working conditions and successful ageing.

Results:

Intellectually stimulating work; that is, substantive complexity, in the beginning of one’s career followed by an accumulation of more intellectually stimulating work throughout working life was associated with higher levels of successful ageing. In contrast, a history of stressful, hazardous or physically demanding work was associated with lower levels of successful ageing.

Conclusions:

Promoting a healthy workplace, by supporting intellectually stimulating work and reducing physically demanding and stressful jobs, may contribute to successful ageing after retirement. In particular, it appears that interventions early in one’s employment career could have positive, long-term effects.

Cognitive Ability in Midlife and Labor Market Participation Among Older Workers: Prospective Cohort Study With Register Follow-up

Background

The study aimed to determine the association of individual cognitive ability in late midlife with labor market participation among older workers.

Methods

This prospective cohort study estimates the risk of long-term sickness absence, disability pension, early retirement, and unemployment from scores on the Intelligenz-Struktur-Test 2000R by combining data from 5076 workers from the Copenhagen Aging and Midlife Biobank with a register on social transfer payments. Analyses were stepwise adjusted for age, gender, physical and psychosocial work environment, health behaviors, occupational social class, education, and chronic diseases.

Results

In the fully adjusted model, low cognitive ability (≥1 standard deviation below the mean for each gender) and high cognitive ability (≥1 standard deviation above the mean for each gender) were not associated with risk of any of the four labor market outcomes.

Conclusion

Individual cognitive ability in late midlife was not associated with risk of long-term sickness absence, disability pension, early retirement, and unemployment in the fully adjusted model. Thus, no direct effect of individual cognitive ability in late midlife was observed on the risk of permanently or temporarily leaving the labor market.

Productive Activities and Risk of Cognitive Impairment and Depression: Does the Association Vary by Gender?

We examine how labor together with social participation protects against cognitive impairment and depression, with a focus on gender differences. Data are drawn from four waves of the Korean Longitudinal Study of Aging (2006-2012). Both paid work and unpaid work are considered labor participation. Social participation includes the frequency of participation in formal social institutions, religious groups, grandparenting, and interactions with family and friends. Using growth curve models, we find that social and labor participation are independently associated with outcomes and effects vary by gender. Religious group activity was beneficial only for women, whereas inability to work was detrimental for men only. Informal social gatherings and labor participation, paid or unpaid, were beneficial for both genders. Findings on gender differences highlight how social identities can shape social roles and confine activity space, and productive engagement, affecting outcomes for mental health in later life.

Do cognitively stimulating activities affect the association between retirement timing and cognitive functioning in old age?

In response to the rising financial pressure on old-age pension systems in industrialised economies, many European countries plan to increase the eligibility age for retirement pensions. We used data from Sweden to examine whether (and if so, how) retirement after age 65 – the eligibility age for basic pension – compared to retiring earlier affects older adults’ (between ages 70 and 85) cognitive functioning. Using a propensity score matching (PSM) approach, we addressed the selection bias potentially introduced by non-random selection into either early or late retirement. We also examined average and heterogeneous treatment effects (HTEs). HTEs were evaluated for different levels of cognitive stimulation from occupational activities before retirement and from leisure activities after retirement. We drew from a rich longitudinal data-set linking two nationally representative Swedish surveys with a register data-set and found that, on average, individuals who retire after age 65 do not have a higher level of cognitive functioning than those who retire earlier. Similarly, we did not observe HTEs from occupational activities. With respect to leisure activities, we found no systematic effects on cognitive functioning among those working beyond age 65. We conclude that, in general, retirement age does not seem to affect cognitive functioning in old age. Yet, the rising retirement age may put substantial pressure on individuals who suffer from poor health at the end of their occupational career, potentially exacerbating social- and health-related inequalities among older people.

Community engagement and dementia risk: time-to-event analyses from a national cohort study

BACKGROUND

There is increasing interest in the potential health benefits of referring older adults to engage in community leisure activities ('social prescribing') to help promote healthy cognitive ageing. However, it remains unclear whether beneficial effects of community engagement are independent of the well-known protective effects of broader structural, functional and subjective social factors.

METHODS

We analysed data from 9550 adults aged 50+ from the English Longitudinal Study of Ageing, with baseline from 2004 to 2005. We assessed associations between different types of community engagement and dementia incidence over a 12-year period. Specifically, we used Cox proportional hazards models, competing risk regressions models, and modified Fine and Gray subdistribution hazards models while controlling for all identified demographic, health-related, and social covariates.

RESULTS

Community cultural engagement (eg, visiting museums, galleries, the theatre) was associated with a lower hazard of developing dementia in older age independent of demographic, health-related and a broad range of social factors, using all three statistical approaches (fully adjusted Cox models: HR 0.58, 95% CI 0.41 to 0.80). Community group engagement (eg, attending clubs or societies) was only associated with dementia prior to adjustment for social factors. Results were robust to sensitivity analyses considering reverse causality, over-adjustment and baseline cognitive function.

CONCLUSION

It is not just social factors that are associated with reduced risk of dementia onset, but community engagement may also be protective, particularly when relating to cultural activities. These findings are of relevance when considering the current interest in social prescribing to support healthy ageing.

Trends in working conditions and health across three cohorts of older workers in 1993, 2003 and 2013: a cross-sequential study

Background

Over the past decades, the number of older workers has increased tremendously. This study examines trends from 1993 to 2013 in physical, cognitive and psychological functioning among three successive cohorts of Dutch older workers. The contribution of the changes in physical and psychosocial work demands and psychosocial work resources to change in functioning is examined. Insight in health of the older working population, and in potential explanatory variables, is relevant in order to reach sustainable employability.

Methods

Data from three cohorts (observations in 1993, 2003 and 2013) of the Longitudinal Aging Study Amsterdam (LASA) were used. Individuals aged 55–65 with a paid job were included (N = 1307). Physical functioning was measured using the Timed Chair Stand Test, cognitive functioning by a Coding Task and psychological functioning by the positive affect scale from the CES-D. Working conditions were deduced from a general population job exposure matrix. Linear and logistic regression analyses were performed.

Results

From 1993 to 2013, time needed to perform the Timed Chair Stand Test increased with 1.3 s (95%CI = 0.89–1.71), to a mean of 11.5 s. Coding Task scores increased with 1.7 points (95%CI = 0.81–2.59), to a mean of 31 points. The proportion of workers with low positive affect increased non-significantly from 15 to 20% (p = 0.088). Only the improvement in cognitive functioning was associated with the change in working conditions. The observed decrease of physically demanding jobs and increase of jobs with higher psychosocial resources explained 8% of the improvement.

Conclusions

Changes in working conditions may not contribute to improved physical and psychological functioning, but do contribute to improved cognitive functioning to some extent. Further adjustment of physical work demands and psychosocial work resources may help to reach sustainable employability of older workers.

Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews

Work environment factors are highly correlated with employees' health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.

Night shift work, long working hours and dementia: a longitudinal study of the Danish Work Environment Cohort Study

OBJECTIVE

Shift work and long working hours are potential risk factors for dementia, but previous studies on shift work, long working hours and dementia are sparse and their findings are conflicting. Therefore, we investigated the effect of night shift work and long working hours on dementia.

DESIGN

A longitudinal study.

SETTING

Denmark.

PARTICIPANTS

3435 occupationally active men and women from the general working population.

METHODS

Work schedule covered day work (reference) and shift schedules without/with night work. Working hours covered <27, 28-36, 37 (reference), 38-44, and ≥45 hours/week. As the primary outcome, we used register-based information about dementia, and estimated incidence rate ratios (IRR) and 95% CI. Estimates were adjusted for gender, age, psychosocial work factors and cardiovascular risk factors.

RESULTS

We identified 85 dementia cases during a mean of 9.8 years of follow-up. We found a positive, but statistically insignificant association between night shift work and dementia (IRR=2.01; 95% CI: 0.87-4.65). Post hoc analyses indicated that this was only due to a higher risk in permanent night workers (IRR=3.25; 95% CI: 1.35-7.83). The dementia risk was also significantly higher among participants working 38-44 hours/week (IRR=2.08; 95% CI: 1.11-3.90) compared with those working 37 hours/week. We found no indications of a higher risk of dementia in participants working <37 hours/week or ≥45 hours/week.

CONCLUSION

We did not find arguments that night shift work or long working hours increased dementia risk in general. However, we found a higher risk of dementia in specific subgroups, that is, permanent night workers and employees with moderately longer weekly working hours than the standard.

The role of personal characteristics, work environment and context in working beyond retirement: a mixed-methods study

Objective

To investigate the role of personal characteristics, work environment and context in working beyond retirement.

Methods

In the current study, a mixed-methods design was applied including quantitative survey data and semi-structured telephone interviews. Respondents (N = 568) were selected from the Study on Transitions in Employment, Ability and Motivation (STREAM). Personal characteristics, work characteristics and contextual factors were measured using a questionnaire at baseline. Concurrently, qualitative data of 30 persons aged over 65 years were gathered. Logistic regression analyses were used to identify quantitative associations and thematic analyses were used for qualitative purposes.

Results

Quantitative data revealed that being in good physical health (OR = 1.80), developmental proactivity (OR = 1.38), interesting work (OR = 2.02), appreciation (OR = 1.62) and voluntary work (OR = 1.58) were associated with working beyond the statutory retirement age. Additionally, qualitative findings suggested that working beyond retirement was mainly driven by the desire to contribute to society (e.g., mentor younger coworkers), and identified the employers’ willingness to hire an older worker despite existing stereotypes as an important precondition.

Conclusions

Working beyond retirement is influenced by physical health and work characteristics, as well as motivational determinants such as the desire to contribute to society. However, to meet the increasing demands for paid jobs by individuals aged over 65 years, the willingness of employers to actually hire them is crucial. Therefore, recognition and utilization of older workers’ potentials is of great importance.

Social housing protects against age-related working memory decline independently of physical enrichment in rats

Longitudinal human studies suggest that as we age, sociality provides protective benefits against cognitive decline. However, little is known about the underlying neural mechanisms. Rodent studies, which are ideal for studying cognition, fail to examine the independent effects of social housing while controlling for physical enrichment in all groups. In this study, rats were socially housed or nonsocially housed throughout their lifespan and tested in the radial arm maze to measure working memory (WM) and reference memory longitudinally at 3 ages. In old age, exclusively, socially housed rats made significantly less WM errors than nonsocially housed rats, while reference memory errors did not differ between groups at any age. Anxiety, as assessed behaviorally and physiologically, could not account for the observed differences in WM. These data provide the first evidence that social enrichment alone can prevent age-related WM deficits in spite of the effects of practice seen in longitudinal designs. Importantly, our model will facilitate future investigations into the mechanisms underlying the neuroprotective benefits of sociability in old age.

Development of reserves over the life course and onset of vulnerability in later life

This Review develops a theoretical framework for the development and onset of vulnerability in later life based on the concept of reserves. We stress the advantages of using the concept of reserves in interdisciplinary life-course studies, compared with related concepts such as resources and capital. We enrich the definition of vulnerability as a lack of reserves and a reduced capacity of an individual to restore reserves. Two dimensions of reserves, originating from lifespan psychology and gerontology, are of particular importance: their constitution and sustainability by behaviours and interaction with the environment (the 'use it or lose it' paradigm) and the presence of thresholds, below which functioning becomes highly challenging. This heuristic approach reveals the potential for a conceptualization of reserves and is exemplified in an empirical illustration. Further interdisciplinary research based on the concept is needed.

Association between Work Related Stress and Health Related Quality of Life: The Impact of Socio-Demographic Variables. A Cross Sectional Study in a Region of Central Italy

The aim of this work is investigate relationship between health-related quality of life and work-related stress and the impact of gender, education level, and age on this relationship. A cross-sectional study was conducted among workers of various setting in Rome and Frosinone. Work-related stress was measured with a demand–control questionnaire and health-related functioning by SF (short form)-12 health survey. There were 611 participants. Men reported high mental composite summary (MCS) and physical composite summary (PCS). In multivariate analysis age, gender (p < 0.001) and job demand (0.045) predicted low PCS. Low MCS predicted poor PCS. Job demand and educational level resulted negatively associated with MCS. In an analysis stratified for age, gender, and educational level, gender and age resulted effect modifier for MCS, gender and education level for PCS. In women increase of decision latitude predict (p = 0.001) an increase in MCS; a low job demand predict high MCS in male (p ≤ 0.001). In younger workers, a lower level of job demand predicted high MCS (<0.001). For PCS, gender and education level resulted effect modifier. In women, high decision latitude predicted higher PCS (p = 0.001) and lower level of job demand results in higher PCS (p ≤ 0.001). Higher educational level resulted predictor of low PCS. Management of risk about work-related stress should consider socio-demographic factors.

Do Effort and Reward at Work Predict Changes in Cognitive Function? First Longitudinal Results from the Representative German Socio-Economic Panel

It has been suggested that work characteristics, such as mental demands, job control, and occupational complexity, are prospectively related to cognitive function. However, current evidence on links between psychosocial working conditions and cognitive change over time is inconsistent. In this study, we applied the effort–reward imbalance model that allows to build on previous research on mental demands and to introduce reward-based learning as a principle with beneficial effect on cognitive function. We aimed to investigate whether high effort, high reward, and low over-commitment in 2006 were associated with positive changes in cognitive function in terms of perceptual speed and word fluency (2006–2012), and whether the co-manifestation of high effort and high reward would yield the strongest association. To this end, we used data on 1031 employees who participated in a large and representative study. Multivariate linear regression analyses supported our main hypotheses (separate and combined effects of effort and reward), particularly on changes in perceptual speed, whereas the effects of over-commitment did not reach the level of statistical significance. Our findings extend available knowledge by examining the course of cognitive function over time. If corroborated by further evidence, organization-based measures in the workplace can enrich efforts towards preventing cognitive decline in ageing workforces.

Exposure shapes the perception of affective touch

Touch is a common occurrence in our lives, where affective and inter-personal aspects of touch are important for our well-being. We investigated whether touch exposure affects hedonic and discriminative aspects of tactile perception. The perceived pleasantness and intensity of gentle forearm stroking, over different velocities, was assessed in individuals reporting to seldom receive inter-personal touch, and in controls who received touch often. The groups did not differ in their stroking intensity judgements, nor in tactile discrimination sensitivity; however, individuals with low touch exposure evaluated the pleasantness of touch differently. These individuals did not differentiate pleasantness over the stroking velocities in the same way as the control group. The pleasantness curve for the low touch exposure group was significantly flatter and they rated 3cm/s stroking as significantly less pleasant. Other physiological and questionnaire measures were obtained and the appreciation of touch from familiar persons was positively related to the pleasantness of touch in controls, but this was not found in low touch exposure individuals. This suggests that the association of human caresses from well-known individuals, with the pleasure derived, may depend on continued exposure to it.

The impact of retirement on age related cognitive decline - a systematic review

BACKGROUND

Knowledge on factors affecting the rate of cognitive decline and how to maintain cognitive functioning in old age becomes increasingly relevant. The purpose of the current study was to systematically review the evidence for the impact of retirement on cognitive functioning and on age related cognitive decline.

METHOD

We conducted a systematic literature review, following the principles of the PRISMA statement, of longitudinal studies on the association between retirement and cognition.

RESULTS

Only seven studies fulfilled the inclusion criteria. We found weak evidence that retirement accelerates the rate of cognitive decline in crystallised abilities, but only for individuals retiring from jobs high in complexity with people. The evidence of the impact of retirement on the rate of decline in fluid cognitive abilities is conflicting.

CONCLUSION

The review revealed a major knowledge gap in regards to the impact of retirement on cognitive decline. More knowledge on the association between retirement and age related cognitive decline as well as knowledge on the mechanisms behind these associations is needed.

Which type of social activities may reduce cognitive decline in the elderly?: a longitudinal population-based study

Background

Previous studies have found that social activities are beneficial for the reduction of cognitive decline (CD) in the elderly. However, knowledge regarding the types of social activities that reduce CD in later life is limited. The aim of this study is to examine which type of social activities reduce CD 4 years later among young-old (Y-O) and old-old (O-O) adults.

Methods

We conducted a secondary analysis using data from cognitively intact adults 65 years of age or older who participated in the Korean Longitudinal Study of Aging (KLoSA). Cognitive function was assessed using the Korean version of the Mini-Mental State Examination (MMSE). We computed CD between 2008 and 2012 by subtracting the Wave 4 MMSE score from the Wave 2 MMSE score. Multivariate linear regression analysis was conducted regarding the effects of social activities on CD after adjusting for age, sex, education, income, marital status, activities of daily living (ADL), instrumental activities of daily living (IADL), chronic diseases, quality of life, depressive symptom, change in depressive symptom, and cognitive functioning at baseline.

Results

Subjects who participated in senior citizen clubs or senior centers at baseline had a lower risk of CD 4 years later than those who did not in Y-O adults. Frequent contact with offspring by phone or letters was associated with reduced CD in O-O adults. Frequent face-to-face contact with offspring was positively associated with CD in O-O adults. Participating in two or more formal social activities was associated with reduced CD compared with nonparticipation in O-O adults.

Conclusion

Encouraging older adults to participate in senior citizen clubs or to have frequent contacts with adult children by phone or letters may help reduce CD in later life among older adults. Participation in a variety of formal social activities may also have a beneficial effect on preventing CD in older adults.

Electronic supplementary material

The online version of this article (doi:10.1186/s12877-016-0343-x) contains supplementary material, which is available to authorized users.