Association between mental demands at work and cognitive functioning in the general population - results of the health study of the Leipzig research center for civilization diseases (LIFE)

Association of nature of work and work-related characteristics with cognitive functioning, life satisfaction and depression among Indian ageing adults

BACKGROUND

Most individuals spend a significant amount of their time at work, and the dynamics at work can potentially influence their overall life, especially health and mental health. The present study tried to understand the association of the nature of work categorized as physically demanding, psychologically demanding, and environmentally hazardous on life satisfaction, cognitive functioning, and depressive symptoms among working middle-aged and older adults in India.

METHOD

We used data from the Longitudinal Ageing Study in India (LASI), Wave 1, collected between 2017 and 2018. The study sample consists of 28,653 working adults aged between 45 and 70. The study measures were assessed using standard tools. Linear regression analysis was employed.

RESULTS

The results indicate that individuals working in less physically demanding (β = 0.06, 99% CI = 0.02-0.09) and not hazardous environments (β = 0.15, 99% CI = 0.09-0.20) had better life satisfaction. Also, not being involved in hazardous work environments increased the likelihood of good cognitive functioning and reduced depressive symptoms (β= -0.17, 99% CI= -0.20- -0.15). However, samples involved in works requiring less psychological demand had an increased likelihood of reduced life satisfaction and increased depressive symptoms.

CONCLUSION

This study's results highlight the importance of creating a conducive working environment for the ageing adults.

2024 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.

Digital neuropsychological test performance in a large sample of uninjured collegiate athletes

Digital neuropsychological test batteries are popular in college athletics; however, well-validated digital tests that are short and portable are needed to expand the feasibility of performing cognitive testing quickly, reliably, and outside standard clinical settings. This study assessed performance on digital versions of Trail Making Test (dTMT) and a modified Symbol Digit Modalities Test (dSDMT) in uninjured collegiate athletes (n = 537; 47% female) using the C3Logix baseline assessment module. Time to complete (dTMT) and the number of correct responses (dSDMT) were computed, transformed into z scores, and compared to age-matched normative data from analogous paper-and-pencil tests. Overall sample performance was compared to normative sample performance using Cohen's d. Sample averages on the dTMT, Part A, and dSDMT were similar to published norms; 97 and 92% of z scores fell within 2 standard deviations of normative means, respectively. The sample averaged faster completion times on dTMT, Part B than published norms, although 98% of z scores were within 2 standard deviations of the normative means. Brief, digitized tests may be useful in populations and testing environments when longer cognitive test batteries are impractical. Future studies should assess the ability of these tests to detect clinically relevant changes following a suspected head injury.

Perceived stress of mental demands at work, objective stress and resilience - an analysis of the LIFE-Adult-study

BACKGROUND

So far, previous research suggests positive effects of mental demands at the workplace. However, it may depend on how stressfull these demands are perceived on an individual level.

OBJECTIVE

The aim was to build on previous research by investigating how mental demands are related to stress, overload, and work discontent and whether this relationship is mediated by individuals resources, such as resilience.

METHOD

A sub-sample of the LIFE Adult Cohort (n = 480) was asked to answer questions on sociodemographic characteristics, objective stress (using the Trier Inventory of Chronic Stress (TICS)), and perceptions of stress with regard to verbal and executive mental demands at work.

RESULTS

According to generalized linear regression models, higher verbal as well as executive mental demands were associated with higher levels of chronic stress, work overload and discontent. Higher levels of resilience were associated with lower levels of these outcomes. Analyses regarding interaction effects revealed that the interaction between resilience and perceived stress of verbal mental demands was significant only in terms of work overload.

CONCLUSION

Higher perceived stressfulness of mental demands was associated with higher chronic stress, work overload and work discontent. Therefore, mental demands should be targeted by occupational interventions that aim to improve job conditions and employees' overall well-being. Besides resilience, other potential influencers or personal resources should be focused on in future studies to develop interventions.

2023 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.

2022 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.

Book-Oriented Environment in Childhood and Current Cognitive Performance among Old-Aged Europeans

INTRODUCTION

Identifying early-life factors that protect against compromised late-life cognition is of great public health interest. We aimed to explore the associations between book-oriented environment in childhood and late-life cognitive performance in the Survey of Health, Ageing and Retirement in Europe (SHARE).

METHODS

The sample included 8,239 individuals aged ≥65 years (N = 8,239) free of stroke, Parkinson's disease, or Alzheimer's disease, who participated in both waves 4 (2011) and 5 (2013) of SHARE. Book-oriented environment was assessed by the self-reported home library size during childhood. Cognitive performance was assessed using tests of memory and verbal fluency. Covariates included education and measures of current health, lifestyle, and financial status. Additionally, interactions with age and education were assessed.

RESULTS

After controlling for potential confounders, having large home libraries was related to better performance on the immediate and delayed memory (β = 0.11 ± 0.02, p < 0.001; β = 0.13 ± 0.02, p < 0.001) and the verbal fluency tests (β = 0.14 ± 0.06, p < 0.001) and to a lesser decline in these domains (β = 0.08 ± 0.01, p < 0.001; β = 0.09 ± 0.02, p < 0.001; and β = 0.09 ± 0.06, p < 0.001, respectively). Significant interactions were observed between library size and age such that larger home library was more strongly associated with improved immediate memory (p = 0.016), delayed memory (p < 0.001), and verbal fluency (p = 0.003) and with less cognitive decline (p = 0.013, p < 0.001, and p = 0.095, respectively) among the younger-old (<80 years) compared to the oldest-old (≥80 years) participants. No effect modification by education was observed.

CONCLUSIONS

These findings suggest that early-life book-oriented environment may be important in shaping cognitive aging.

2021 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth-leading cause of death in the United States and the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID-19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain - both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID-19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.

Job Strain and Late-Life Cognition: Findings From the Puerto Rican Elderly Health Conditions Study

Objectives: We examined associations between job strain and cognitive aging in a sample of older Puerto Ricans. Methods: Members of the Puerto Rican Elderly: Health Conditions study, aged 60-100 years at baseline, participated. Job strain indicators were quantified from O*NET (n = 1632) and a matrix of Job Content Questionnaire scores (JCQ; n = 1467). Global cognition was assessed twice across 4 years. Results: Controlling for age, sex, depressive symptoms, financial problems, hypertension, diabetes, childhood economic hardship, low job control and high job strain were consistently associated with greater cognitive decline. Adding education attenuated these associations. High education strengthened the JCQ job control-cognitive change link. Discussion: Low job control and high job strain may accelerate cognitive aging in this population. However, it may be more difficult to disentangle the intersecting roles of education and job strain in cognitive aging among older Puerto Ricans relative to older adults from contiguous United States or Europe.

The Relationship between Clinic Visit Accompanied by Family and Dementia Severity in Taiwan

INTRODUCTION

This study analyzes the severity of dementia status with clinical dementia rating (CDR) score distribution among patients according to various family functional and sociodemographic issues.

METHODS

A cross-sectional study was performed in a regional hospital in Central Taiwan. The sample consisted of 318 patients who came to the clinic from May 2018 to April 2019, and who were diagnosed by the physicians with CDR scores ≧ 0.5. The Chi-Square test and binary logistic regression analyses were performed for inferential statistical analysis.

RESULTS

The mean age of the sample was 78.7 ± 8.51 years, and 61.6% of the samples' CDR scores were equal or less than 1.0. Patients visiting the clinic were accompanied by spouses (21.7%), sons or daughters-in-law (40.6%), daughters (23.6%). Of the sample, 142 (44.3%) patients live with sons. Patients with a lower educational level had higher CDR scores. Compared to the patients who went to the clinic by themselves, the higher OR values of CDR scores ≧ 2 are found in patients who were accompanied by other relatives (OR = 18.871, 95% C.I. = 3.117-114.237, p = 0.001), or spouse (OR = 10.783, 95% C.I. = 1.996-58.245, p = 0.006).

CONCLUSION

The family member who accompanied the patient to a clinic visit and the patient's educational level are both significant issues relating to the severity of dementia.

Socio-demographic characteristics and cognitive performance in oldest old subjects asking for driving license renewal

Background

No papers have examined the relationship between socio-demographic characteristics and cognitive performance in oldest old subjects (i.e, > = 80 years old) asking for driving license renewal. We hypothesize that, even in this highly functioning population, age, sex, and education influence cognitive performance, expressed as total or single domain (raw) test scores. This research question allows to describe, identify, and preserve independence of subjects still able to drive safely.

Methods

We examined cross-sectionally a cohort of > = 80 years old subjects (at enrollment) asking for driving license renewal in the Milan area, Italy, 2011–2017. The analysis was restricted to 3378 first and 863 second visits where individual’s cognitive performance was evaluated. According to the study protocol, the Mini Mental State Examination (MMSE) test was administered at the first visit for driving license renewal and the Montreal Cognitive Assessment (MoCA) test at the second visit, following an additional renewal request. Ordinary least squares regression models were fitted at either time points. In each model, we included age, sex, and education as independent variables, whereas the dependent variable was total or single domain score for either test. In total, we fitted 15 regression models to assess our research hypothesis.

Results

The median subject in our sample reached the maximum scores on domains targeting operational and tactical abilities implied in safe driving, but had sub-optimal scores in the long-term memory domain included among the strategic abilities. In multiple models, being > = 87 (versus 80- < 86 years old) significantly decreased the mean total and memory scores of MMSE, but not those of the MoCA. Females (versus males) had significantly higher mean total and long-term memory scores of either tests, but not other domains. Mean total and single domain scores increased for increasing education levels for either tests, with increments for high school graduates being ~ 2 of those with (at most) a junior high school diploma.

Conclusions

Sex and education, as well as age to a lesser extent, predict cognitive functioning in our oldest old population, thus confirming that concepts like cognitive reserve and successful ageing are valuable constructs in the identification of older subjects still able to drive.

2020 Alzheimer's disease facts and figures

This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid-century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.

Are social conflicts at work associated with depressive symptomatology? Results from the population-based LIFE-Adult-Study

Background

Psychosocial stressors in the workplace can be detrimental to mental health. Conflicts at work, e.g. aggression, hostility or threats from coworkers, supervisors or customers, can be considered a psychosocial stressor, possibly increasing risk for depressive symptoms. Existing studies, however, differ in the assessment of social conflicts, i.e. as individual- or job-level characteristics. Here, we investigated the association between conflicts at work assessed as objective job characteristics, and depressive symptomatology, using data from a large population-based sample. Additionally, we investigated gender differences and the impact of personality traits and social resources.

Methods

We used data from the population-based LIFE-Adult-Study from Leipzig, Germany. Information on conflicts at work, assessed as job characteristics, were drawn from the Occupational Information Network, depressive symptoms were assessed via the Center for Epidemiological Studies Depression Scale. Multilevel linear regression models with individuals and occupations as levels of analysis were applied to investigate the association between conflicts at work and depressive symptoms.

Results

Our sample included 2164 employed adults (age: 18-65 years, mean: 49.3, SD: 7.9) in 65 occupations. No association between conflicts s at work and depressive symptomatology was found (men: b = - 0.14; p = 0.74, women: b = 0.17, p = 0.72). Risk for depression was mostly explained by individual-level factors like e.g. neuroticism or level of social resources. The model showed slightly higher explanatory power in the female subsample.

Conclusion

Conflicts at work, assessed as objective job characteristics, were not associated with depressive symptoms. Possible links between interpersonal conflict and impaired mental health might rather be explained by subjective perceptions of social stressors and individual coping styles.

Retirement and decline in episodic memory: analysis from a prospective study of adults in England

BACKGROUND

Work has been associated with cognitive health. We examined whether retirement from work is associated with a decrease in episodic memory and whether this effect differs when considering workers' occupational class.

METHODS

In this prospective study using the English Longitudinal Study of Ageing (ELSA), we examined 1629 persons aged 50-75 years who were in paid work at baseline. A two-slope random effects linear regression centred at retirement was used to study the effect of retirement on episodic memory. The potential effect modification by occupational class was examined.

RESULTS

While memory trajectories show slightly decreasing memory scores before and afterretirement, the decreasing rates for both periods were similar [episodic memory β2b-β2a= -0.03, 95% confidence interval (CI) -0.08, 0.02]. When stratifying by occupational class, there was also no substantial difference in episodic memory trajectories before and after retirement. However, the lower occupational class showed a clear decline in episodic memory with time (pre-retirement β2a = -0.11, 95% CI -0.19, -0.03; post-retirement β2b = -0.13, 95% CI -0.19, -0.07) which was not evident for the higher occupational classes.

CONCLUSIONS

Our results show no observable difference in trajectories of change in episodic memory before and after retirement. However, the steeper memory decline in workers belonging to the lower occupational class may limit their prospect of prolonging their working lives. Hence enrichment programmes for the prevention of memory decline for these workers should be considered.

Concepts of Mental Demands at Work That Protect Against Cognitive Decline and Dementia: A Systematic Review

Objective:

Workplace-related mental demands (WPMDs) are considered to be protective factors for cognitive health in old age and are linked to delayed onset of dementia. Yet, what exactly is meant by WPMDs differs greatly between studies, putting an enormous challenge on researchers and practitioners. Aim of our study was thus to create a systematic overview on WPMD concepts and to depict their associations with dementia and cognitive decline. Thereby, we want to create a solid basis for further work and implementation.

Data Source:

PubMed, PsycINFO, Web of Science.

Inclusion/Exclusion Criteria:

We included observational studies with populations older than 18 that addressed the association between WPMDs and dementia/cognitive functioning and that were published as journal articles. We excluded studies with emotional and physical demands, stress, and organizational frameworks such as exposure variables and quality of life, depressive symptoms, burnout, and Parkinson as outcome. Furthermore, we excluded study populations younger than 18 and students.

Data Extraction:

Standardized search string.

Data Synthesis:

Based on theoretical concepts.

Results:

Thirty-four studies that employed concepts of WPMDs in 5 different categories: complexity with people/data/things, cognitive demands, job control, novelty, and mental workload.

Discussion:

Challenges associated with categorizing WPMDs as well as theoretical and measurement-related implications are discussed.

Conclusion:

This review helps to better understand how workplaces can contribute to later life cognitive fitness, and it offers a conceptual overview for practitioners that want to create more protective working environments or improve existing ones.

Physical fitness and psycho-cognitive performance in the young and middle-aged workforce with primarily physical versus mental work demands

Aim

The purpose of this study was to examine physical fitness and psycho-cognitive performance and their associations in young and middle-aged workers with primarily physical versus mental work demands.

Subjects and methods

Healthy young and middle-aged workers (73 men, age = 33 ± 7 years; 75 women, age = 35 ± 9 years) were recruited from German small-to-medium-sized enterprises (< 250 employees) and classified into groups with primarily mental (MD) or physical demands (PD) at work. Participants were tested for cardiorespiratory fitness, trunk flexor/extensor muscular endurance, handgrip strength, balance, leg muscle power, perceived stress, cognitive performance, and work ability.

Results

Ninety-four workers were allocated to the MD (53% females) and 54 to the PD (46% females) groups. The MD group showed significantly better balance, trunk extensor muscular endurance, and cognitive performance (p < 0.035, 0.35 ≤ d ≤ 0.55) and less stress compared with the PD group (p < 0.023, d = 0.38). Group-specific Spearman rank correlation analysis (rS) revealed significant small-to-medium-sized correlations between physical fitness and cognitive performance (− 0.205 ≤ rS ≤ 0.434) in the MD and PD groups. Significant small-to-medium-sized correlations were found for physical fitness and stress/work ability (0.211 ≤ rS ≤ 0.301) in the MD group only. Further, associations of trunk extensor muscular endurance and work ability were significantly higher in the MD group (rS = 0.240) compared with the PD group (rS = − 0.141; z = 2.16, p = 0.031).

Conclusions

MD workers showed better physical fitness measures (balance, trunk extensor muscular endurance) and cognitive performance and lower levels of perceived stress compared with PD workers. Small-to-medium-sized associations between physical fitness and psycho-cognitive performance measures indicate that gains in physical fitness may at least partly contribute to psycho-cognitive performance and/or vice versa, particularly in MD workers.

Development of an e-health education program at the workplace using formative research - Technologies for improving quality of life

BACKGROUND

e-Learning, a means by which to expand people's access to information can be effective in promoting health in the workplace. This study to present steps in the development of an e-health education program at the workplace.

OBJECTIVE

This study aimed to present all steps of develop a telehealth education program for computer users using formative research to identify themes to health education for workers.

METHODS

A team of expert conducted focus groups with administrative workers (n = 36 participants) to identify thematic health to the development of program. Three meetings were audio video recorded, and notes. All data were based on constant analysis, classical content analysis and keywords in-context.

RESULTS

The content of the nine audio videos included four musculoskeletal health topics (Walking Program, Back School, Muscle Relaxation Techniques, and Work-related Musculoskeletal Diseases); three to healthy diet (Eating and Commensality, Ultra-processed Food and Food labeling, and Oil and Fat); two to mental health (Burnout Syndrome and the Meaning of work).

CONCLUSION

The proposed steps in the development of a workplace e-health education program were successfully achieved. The engagement of the workers' staged focus groups was fundamental to the choice of themes relevant to the population in question.

The age-dependent relationship between resting heart rate variability and functional brain connectivity

Resting heart rate variability (HRV), an index of parasympathetic cardioregulation and an individual trait marker related to mental and physical health, decreases with age. Previous studies have associated resting HRV with structural and functional properties of the brain - mainly in cortical midline and limbic structures. We hypothesized that aging affects the relationship between resting HRV and brain structure and function. In 388 healthy subjects of three age groups (140 younger: 26.0 ± 4.2 years, 119 middle-aged: 46.3 ± 6.2 years, 129 older: 66.9 ± 4.7 years), gray matter volume (GMV, voxel-based morphometry) and resting state functional connectivity (eigenvector centrality mapping and exploratory seed-based functional connectivity) were related to resting HRV, measured as the root mean square of successive differences (RMSSD). Confirming previous findings, resting HRV decreased with age. For HRV-related GMV, there were no statistically significant differences between the age groups, nor similarities across all age groups. In whole-brain functional connectivity analyses, we found an age-dependent association between resting HRV and eigenvector centrality in the bilateral ventromedial prefrontal cortex (vmPFC), driven by the younger adults. Across all age groups, HRV was positively correlated with network centrality in the bilateral posterior cingulate cortex. Seed-based functional connectivity analysis using the vmPFC cluster revealed an HRV-related cortico-cerebellar network in younger but not in middle-aged or older adults. Our results indicate that the decrease of HRV with age is accompanied by changes in functional connectivity along the cortical midline. This extends our knowledge of brain-body interactions and their changes over the lifespan.

Mental Work Demands and Late-Life Cognitive Impairment: Results From the Shanghai Aging Study

OBJECTIVE

The aim of this study is to explore the association between mental work demands (MWDs) and late-life cognition among Chinese older adults.

METHOD

Data were drawn from the baseline of the Shanghai Aging Study.

RESULTS

Among 3,546 participants, the mean MWDs index of participants with dementia, mild cognitive impairment (MCI), and cognitive normal were 2.8 ( SD = 0.5), 2.8 ( SD = 0.5), and 2.9 ( SD = 0.4), respectively. Mini Mental State Examination (MMSE) scores in group with low MWDs level decreased more dramatically by increasing age than that in groups with middle and high MWDs level ( p < .001). In a subgroup of participants with education ≥6 years, we found a positive correlation between MWDs index and MMSE score after adjusting for gender, age, body mass index, income, living alone, smoking, drinking, anxiety, depression, heart disease, hypertension, diabetes, and APOE-ε4 (apolipoprotein), by generalized linear model analysis ( p < .001).

DISCUSSION

Our results suggest that long-time mental work stimulation during adulthood would have potential benefits to late-life cognition.

Effects of Degree of Urbanization and Lifetime Longest-Held Occupation on Cognitive Impairment Prevalence in an Older Spanish Population

Our aim was to estimate the prevalence of cognitive impairment in rural and urban elderly populations and to examine the relationship between lifetime occupation and general cognitive performance. A cross-sectional study was carried out covering a representative sample (n = 749) of adults aged ≥65 years. Two categories were created to define the degree of urbanization using a criterion of geographical contiguity in combination with a minimum population threshold: densely populated (urban) areas and intermediate-thinly populated (rural) areas. Occupational histories were ranked by skill level requirements according to the Spanish National Classification of Occupations. Prevalence estimates of cognitive impairment were measured with the Mini-Mental State Examination. Results show that rural residence was not significantly associated with higher risk of cognitive impairment. A protective effect of cognitive demands at work against age-related cognitive decline was observed. However, this effect was not independent of confounder factors, such as age and education. A low overall prevalence of cognitive impairment was observed (6.5%), compared with previous estimates, possibly due to the sample selection in senior centers. Occupation during active life is not an isolated protective factor against cognitive impairment, and it is closely related to educational level. In future geriatric programs, description of both factors should be taken into consideration in screening older adults at increased risk of cognitive impairment and dementia.

Computerized Analysis of Verbal Fluency: Normative Data and the Effects of Repeated Testing, Simulated Malingering, and Traumatic Brain Injury

In verbal fluency (VF) tests, subjects articulate words in a specified category during a short test period (typically 60 s). Verbal fluency tests are widely used to study language development and to evaluate memory retrieval in neuropsychiatric disorders. Performance is usually measured as the total number of correct words retrieved. Here, we describe the properties of a computerized VF (C-VF) test that tallies correct words and repetitions while providing additional lexical measures of word frequency, syllable count, and typicality. In addition, the C-VF permits (1) the analysis of the rate of responding over time, and (2) the analysis of the semantic relationships between words using a new method, Explicit Semantic Analysis (ESA), as well as the established semantic clustering and switching measures developed by Troyer et al. (1997). In Experiment 1, we gathered normative data from 180 subjects ranging in age from 18 to 82 years in semantic ("animals") and phonemic (letter "F") conditions. The number of words retrieved in 90 s correlated with education and daily hours of computer-use. The rate of word production declined sharply over time during both tests. In semantic conditions, correct-word scores correlated strongly with the number of ESA and Troyer-defined semantic switches as well as with an ESA-defined semantic organization index (SOI). In phonemic conditions, ESA revealed significant semantic influences in the sequence of words retrieved. In Experiment 2, we examined the test-retest reliability of different measures across three weekly tests in 40 young subjects. Different categories were used for each semantic ("animals", "parts of the body", and "foods") and phonemic (letters "F", "A", and "S") condition. After regressing out the influences of education and computer-use, we found that correct-word z-scores in the first session did not differ from those of the subjects in Experiment 1. Word production was uniformly greater in semantic than phonemic conditions. Intraclass correlation coefficients (ICCs) of correct-word z-scores were higher for phonemic (0.91) than semantic (0.77) tests. In semantic conditions, good reliability was also seen for the SOI (ICC = 0.68) and ESA-defined switches in semantic categories (ICC = 0.62). In Experiment 3, we examined the performance of subjects from Experiment 2 when instructed to malinger: 38% showed abnormal (p< 0.05) performance in semantic conditions. Simulated malingerers with abnormal scores could be distinguished with 80% sensitivity and 89% specificity from subjects with abnormal scores in Experiment 1 using lexical, temporal, and semantic measures. In Experiment 4, we tested patients with mild and severe traumatic brain injury (mTBI and sTBI). Patients with mTBI performed within the normal range, while patients with sTBI showed significant impairments in correct-word z-scores and category shifts. The lexical, temporal, and semantic measures of the C-VF provide an automated and comprehensive description of verbal fluency performance.

The Effects of Aging, Malingering, and Traumatic Brain Injury on Computerized Trail-Making Test Performance

The trail making test (TMT) is widely used to assess speed of processing and executive function. However, normative data sets gathered at different sites show significant inconsistencies. Here, we describe a computerized version of the TMT (C-TMT) that increases the precision and replicability of the TMT by permitting a segment-by-segment analysis of performance and separate analyses of dwell-time, move-time, and error time. Experiment 1 examined 165 subjects of various ages and found that completion times on both the C-TMT-A (where subjects connect successively numbered circles) and the C-TMT-B (where subjects connect circles containing alternating letters and numbers) were strongly influenced by age. Experiment 2 examined 50 subjects who underwent three test sessions. The results of the first test session were well fit by the normative data gathered in Experiment 1. Sessions 2 and 3 demonstrated significant learning effects, particularly on the C-TMT-B, and showed good test-retest reliability. Experiment 3 examined performance in subjects instructed to feign symptoms of traumatic brain injury: 44% of subjects produced abnormal completion times on the C-TMT-A, and 18% on the C-TMT-B. Malingering subjects could be distinguished from abnormally slow controls based on (1) disproportionate increases in dwell-time on the C-TMT-A, and (2) greater deficits on the C-TMT-A than on the C-TMT-B. Experiment 4 examined the performance of 28 patients with traumatic brain injury: C-TMT-B completion times were slowed, and TBI patients showed reduced movement velocities on both tests. The C-TMT improves the reliability and sensitivity of the trail making test of processing speed and executive function.