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‘Occupational social and mental stimulation and cognitive decline with advancing age’
Abstract
Objective: this study investigates the role of social and mental occupational characteristics in cognitive decline after
retirement.
Methods: the study included 1,048 subjects aged ≥65 years from the Three City cohort. Participants were evaluated at
home at the initial visit and at 2-year intervals for a period of 12 years. The study includes detailed assessments of cognition,
health and information about the subjects’ main occupation. The four cognitive tests have been grouped into one latent factor.
Three independent raters specialised in employment were asked to evaluate the level of social and intellectual stimulation
for each occupation, which was then rated as low, medium and high.
Results: after controlling for potential confounding factors, no association was found between higher levels of social stimulation
at work and baseline cognition (medium score, P = 0.440; high score, P = 0.700) as compared with a low level. While
cognitive trajectories were initially similar between high and medium levels of social stimulation compared with that of a low
level, with advancing age this association diverged whereby more social stimulation during work years was related to accelerated
cognitive decline that further grew in magnitude with older age. For mental stimulation, differences were only observed at baseline,
with greater levels of mental stimulation during work years being associated with better cognitive performance (medium
score, β = 0.573, P = 0.015; and high score, β = 0.510; P = 0.090) compared with a low level of mental stimulation.
Conclusion: workers retiring from occupations characterised by high levels of social stimulation may be at risk of accelerated
cognitive decline with advancing age.
... Some studies have shown that CCT produces improvements in general cognitive performance in older adults and specifically, in verbal and nonverbal memory, working memory, processing speed and visuospatial skills; however, no significant effects have been found in attention and EF (Chan et al., 2016;Cheng et al., 2012;Grotz et al., 2018;Lampit et al., 2014;Laver et al., 2015;Vaportzis et al., 2018). On the other hand, no studies have been identified in whose intervention designs CR has been taken into account; moreover, some even exclude participants with primary education or who do not have a very high level of instrumental activities of daily living (IADLs) (Ten Brinke et al., 2018). ...
... As previously mentioned, some studies have demonstrated that ECC improves overall cognitive performance in older adults, particularly in areas such as verbal and non-verbal memory, working memory, processing speed, and visuospatial skills. However, no significant effects have been observed in attention and executive functions (Grotz et al., 2018;Lampit et al., 2014). To address these vulnerable areas, our study includes reinforcement sessions specifically designed to target these aspects of cognitive deterioration. ...
... The following sociodemographic variables were studied: gender, age, level of education, civil status, and mental occupational, physical occupational, and clinical states, such as high blood pressure (HBP), diabetes, hypercholesterolemia, obesity, and cerebrovascular accidents (CVA). Moreover, an analysis of the subgroups was considered according to the level of education (primary/higher), physical occupational status and mental occupational status based on three levels: low, medium, and high (for each) [33]. ...
... When analyzing the occupational elements, our study revealed that men developed mental capacities when they worked better than women. Similar results were reported by other authors, who demonstrated that those occupations involving higher mental demands enhance cognitive functioning, which may come over as better cognitive performance after retirement in older adults [21,33]. Mental demand has been considered a factor that protects older adults from functional loss [76]. ...
Older adults are particularly vulnerable to cognitive impairment with age, and gender differences are remarkable. However, there is very little evidence to identify both baseline cognitive and occupational gender differences prior to older adults’ retirement to design more efficient personalized cognitive interventions. This descriptive observational study examined gender differences in initial cognitive performance in 367 older adults with subjective memory complaints from a primary healthcare center in Zaragoza (Spain). To evaluate initial cognitive performance, the Spanish version of the Mini-Mental State Examination (MEC-35) and the set test were used to measure verbal fluency. Sociodemographic and clinical characteristics were evaluated, and cognitive and occupational differences were analyzed per gender. Men had higher educational and occupational levels, were older and more of them were married (p < 0.001) than women. Regarding cardiovascular risk factors, diabetes and cerebrovascular accidents were more frequent in women, while hypercholesterolemia and obesity were more frequent in men (p < 0.001). High blood pressure was more frequent in women, but not significantly so (p = 0.639). Global cognition was higher in men (p < 0.001) for attention, calculation, and language (p < 0.001). Verbal fluency was higher in women, but the difference was not statistically significant (p = 0.105). These results could be generalized to other health centers in the province and other Spanish autonomous communities as their sociodemographic variables are similar. Individualized interventions that adapt to gender, cognitive and initial occupational performance should be developed and adapted to elderly populations living in the general community to maintain their cognitive capacity and prevent their cognitive impairment and the social health costs this would imply.
... These findings align with several studies demonstrating that higher occupational complexity is associated with reduced cognitive decline (e. g., Hülür et al., 2019;Pool et al., 2016;Soh et al., 2023). Other research has shown that higher levels of occupational complexity predict more rapid cognitive decline later in life (e.g., Grotz et al., 2018;Hyun, Katz, Lipton, & Sliwinski, 2021), a phenomenon interpreted as the 'compression of cognitive morbidity' (Fries, 1980;Zahodne et al., 2019). Here, we modeled average changes in cognition (fixed effects) using a quadratic function to capture non-linear acceleration at later ages; however, individual differences in changes (random effects) were limited to a linear slope component. ...
A century of psychometric research has shown that intelligence is robustly associated with occupational status. Despite a rapidly aging global workforce, occupational differences in cognitive decline remain under-investigated. In a large sample of middle-aged and older adults (N = 5,542; age 41–97 years; 70.6% female), we compared age-based trajectories of general fluid cognition across occupational groups (categorized both by specialization area and skill level). Occupational grouping accounted for 18.6% of variability in baseline cognitive performance and 3.9% of variability in rates of decline. Cognitive differences across occupational groups generally followed a skill gradient. These differences were largely retained with increasing age—although between-group variability in rates of decline were also present. Moreover, occupation-cognition associations remained significant after adjustment for education (occupation contributed an additional 5.9% and 1.8% to explained variation in baseline cognitive performance and decline in performance, respectively). Having more hobbies in later life accounted for an additional 2.7% and 1.2% in explained variation for baseline differences and declines in cognition, respectively. These associations were minimally affected by further adjustment for sociodemographic and lifestyle covariates, including retirement status. The marked contrast between the cognitive trajectories of academic professionals vs. those of other occupational groups suggests that long-term immersive intellectual engagement may provide tangible benefits for cognitive aging.
... In terms of lifestyle, poor nutrition and physical inactivity worsen both physical disability and cognitive function (45,46). Previous studies have also revealed that education, income, occupation, and residential surroundings can differentially affect the rate of cognitive and disability decline in the older people (47)(48)(49). However, studies among China's older population have mainly focused on the effects of factors such as gender, disease, and education (50); there is a lack of comprehensive analysis of multiple factors. ...
Introduction
Dementia and physical disability are serious problems faced by the aging population, and their occurrence and development interact.
Methods
Based on data from a national cohort of Chinese people aged 60 years and above from the China Health and Retirement Longitudinal Survey from 2011 to 2018, we applied the group-based trajectory model to identify the heterogeneous trajectories of cognitive function and physical disability in participants with different physical disability levels. Next, multinomial logistic regression models were used to explore the factors affecting these trajectories.
Results
The cognitive function trajectories of the Chinese older people could be divided into three characteristic groups: those who maintained the highest baseline level of cognitive function, those with a moderate baseline cognitive function and dramatic progression, and those with the worst baseline cognitive function and rapid–slow–rapid progression. The disability trajectories also fell into three characteristic groups: a consistently low baseline disability level, a low initial disability level with rapid development, and a high baseline disability level with rapid development. Compared with those free of physical disability at baseline, a greater proportion of participants who had physical disability at baseline experienced rapid cognitive deterioration. Education, income, type of medical insurance, gender, and marital status were instrumental in the progression of disability and cognitive decline in the participants.
Discussion
We suggest that the Chinese government, focusing on the central and western regions and rural areas, should develop education for the older people and increase their level of economic security to slow the rate of cognitive decline and disability among this age group. These could become important measures to cope with population aging.
... The subdivision of both the physical occupational status and mental occupational status variables was made according to three levels: low, medium, and high. 30 To assess interests, the Modified Interest Checklist 31 was used. Subsequently, this variable was dichotomised into three categories. ...
Background
By 2050, the number of people aged 60 years and older will have doubled worldwide and the most common mental disorders in this age group are currently depressive symptoms and anxiety. This study aimed to analyze the Basic and Instrumental Activities of Daily Living (BADLs and IADLs, respectively) in older adults; socio‐demographic, clinical, lifestyle, and environmental variables; and cognitive impairment related to the appearance of depressive symptoms and anxiety.
Material and Methods
A cross‐sectional observational study was conducted with 327 participants aged ≥65 years in primary care. The variables were Yesavage's Geriatric Depression Scale, the Goldberg Anxiety Subscale, socio‐demographic, clinical, lifestyle, environmental variables, BADLs, IADLs, and the Spanish version of the Mini‐Mental State Examination.
Results
An analysis of variance was carried out for the predictive multiple linear regression models. ‘≥ 1 chronic pathology’ and ‘low dependency’ in BADL are negatively associated with anxiety, while ‘physical activity’ and ‘low dependency’ in BADL are associated with positive factors for depressive symptoms.
Conclusions
Predictor variables could improve the early detection of anxiety and depressive symptoms by general practitioners and serve as a basis for future studies and personalised‐adapted cognitive stimulation programs.
... As formal activities provide opportunities to interact with new people and complete specific tasks, participants are more likely to engage cognitive processes to learn, retain, and express information and ideas, thereby promoting cognitive health (Lee & Kim, 2016;Saajanaho et al., 2016). In this regard, a lack of formal activities can be particularly detrimental to the cognitive function of older adults who require more active social stimulation on a daily basis during post-retirement life, a period that is characterized by a significant reduction in social interaction (Grotz et al., 2018). For instance, a lack of formal social activities can impair the state of consciousness and attention processes necessary for task performance, as well as the executive processes that serve to regulate information and complex thinking abilities (Fratiglioni et al., 2004;Kelly et al., 2017). ...
Objectives:
This study investigates the cognitive function trajectories associated with prolonged social isolation, while distinguishing between a lack of informal social contact and a lack of formal social activity as the source of social isolation.
Methods:
Data from the Korean Longitudinal Study of Ageing spanning 12 years between 2006 and 2018 were analyzed. A lack of frequent informal social contact or formal social activity was used to assess social isolation, and cognitive function was measured by Korean Mini-Mental State Examination. Fixed effects regression models were used to account for unobserved individual-level confounders.
Results:
A prolonged absence of frequent informal social contact was linked to a decline in cognitive function up to the three waves of exposure (b = -2.135), but cognitive function has not declined further since then. A persistent lack of formal social activity was associated with a decline in cognitive function up to the fifth and subsequent waves of exposure (b = -3.073). No gender differences were observed in these relationships.
Conclusion:
Prolonged social isolation, particularly a lack of formal social activity, can pose a significant threat to the cognitive health of older adults.
... This is the most basic classification possible, given that this variable was not initially considered for the inference analysis of the results. The subdivision of physical occupational status and mental occupational status was made according to three levels: low, medium, and high for each, in accordance with the classification by Grotz et al. (2017). Nucleus of family coexistence was subdivided in two categories, living alone, and living with others family members. ...
Purpose of the research:
Cognitive stimulation (CS) is defined as activities that involve cognitive processing, usually conducted in a social context and often in a group. This study aims to evaluate the effects of a personalized-adapted CS program in older adults on global cognition, neuropsychological constructs, activities of daily living (ADLs), and mood.
Materials and methods:
The randomized controlled single-blind trial involving 337 participants (235 women and 102 men) ≥ 65 years of age in a Primary Care centre classified participants into 4 groups: 101 for the no deterioration (ND) group; 100 for the subjective cognitive impairment (SCI) group; 108 for the level deterioration (LD) group and 28 for the moderate deterioration group. The intervention consisted of a personalized CS adapted program for 10 weeks. Follow-up assessments were conducted post-intervention, and at 6 and 12 months. The primary outcome was global cognition measured by the Spanish version of the Mini-Mental State Examination. The secondary outcomes were measured by the Barthel Index, the Lawton and Brody Scale, the Goldberg Questionnaire (anxiety sub-scale) and the abbreviated Yesavage Geriatric Depression Scale.
Results:
The intervention showed a tendency of improvement on global cognition and different cognitive functions for groups with no deterioration or level deterioration. The group with moderate deterioration improved in anxiety.
Conclusions:
The findings demonstrated benefits in global cognition, different cognitive functions, semantic fluency, IADLs and anxiety. The most benefits are given in the intermediate groups, SCI, and LD. Moreover, the intervention works by increasing the benefits in the different phases.
... An attempt was made to establish the most basic classification possible as this variable was not initially considered for the inference analysis of the results. Subdivision of physical occupational status and mental occupational status was made according to three levels: low, medium, and high for each based on the classification of Grotz [36]. The clinical variables assessed were hypertension, diabetes, hypercholesterolemia, obesity, and cerebrovascular accident. ...
Age-related subjective memory complaints (SMC) are a common concern among older adults. However, little is known about the effects of cognitive stimulation (CS) interventions on subjective memory complaints. The aim of this study was to analyse the effectiveness of a CS programme on global cognition and cognitive functions of older adults with SMC. A randomised clinical trial was conducted on older adults with SMC, including 308 participants ≥65 years of age assessed 6 and 12 months after the intervention. The assessment instrument was the Spanish version of the Mini-Mental State Examination (MEC-35), and all domains of the instrument were assessed. For statistical analysis, the data were analysed using robust ANOVA with means truncated at 20% utilising a two-way repeated measures model, with between (groups) and within (measurements) factors. In post hoc tests, a Wilcoxon signed-rank test of exact permutations between groups and Bonferroni correction were applied. In post hoc between-group tests, significant differences were found: (1) post-treatment in MEC-35, temporal orientation, short-term memory (STM), global language and praxis, and language and praxis (p ≤ 0.005); (2) at 6 months in MEC-35, global orientation, temporal orientation, and STM (p = 0.005); (3) at 12 months in MEC-35, global orientation, temporal orientation, STM, global language and praxis, and language (p = 0.005). This study shows benefits in global cognition and orientation, temporal orientation, STM, and language in older adults with SMC.
... This is the most basic classification possible, given that this variable was not initially considered for the inference analysis of the results. The subdivision of physical occupational status and mental occupational status was made according to three levels: low, medium, and high for each of them, in accordance with the classification used by Grotz et al. [27]. ...
The efficacy of cognitive stimulation programs for the elderly is sufficiently documented. However, few studies have addressed the effectiveness of language stimulation programs by cognitive levels in this population. This randomized controlled trial was conducted on 308 participants from a primary care center and followed the CONSORT guidelines. A stratified randomization was carried out. The primary variable was the MEC-35, validated Spanish version of the Mini-Mental State Examination (MMSE). The secondary outcome variable was set-test, which evaluates verbal fluency in four categories. These tests were assessed for all outcome measures at baseline, at 10 weeks, at 6 months, and 1 year after the intervention. The intervention consisted of 10 sessions of 45 min/week for 10 weeks through mental activation notebooks that comprehensively work on the different cognitive functions. The results show that the comparisons between the control and intervention group turn out to be significant (p < 0.05) at the three time points. The comprehensive cognitive stimulation program has made it possible to improve the global aspects of cognition, language proficiency, and verbal fluency. To optimize and maintain these results, it is necessary to consider other clinical, functional, psychological, and occupational aspects, as well as related educational aspects, which prevent mild cognitive impairment.
... The following socio-demographic variables were studied: gender, age, level of education, marital status, and mental occupational, physical occupational, and clinical statuses such as AHT, diabetes, hypercholesterolemia, obesity, and CVA. An analysis of the subgroups was considered according to both the physical occupational and mental occupational statuses based on three levels for each one: low, medium, high [33]. The presence of SMC was evaluated by the question: Do you have complaints about your memory? ...
Introduction: Successful aging lies in cognitive and functional maintenance, and in the optimal performance of daily tasks that keep the elderly free of disability and dependence. However, there is little evidence for functional differences for gender and age, and how cognitive and physical demands in past working lives can affect them, to design more personalized occupational therapy interventions to prevent functional and cognitive impairment. Method: This observational descriptive study evaluated 367 older adults living in a community with subjective memory complaints and scored between 24 and 35 with the Spanish version of the “Mini-Mental State Examination (MEC-35)”. Basic activities of daily living (BADL) were studied with the Barthel Index, while instrumental ADL (IADL) were examined with the Lawton–Brody scale. Functional differences for gender, age, and physico-mental occupation were examined. Results: The significant differences found for gender indicated that men did better in BADL (p = 0.026) and women better performed IADL (p < 0.001). Differences between age groups suggest that the younger group (aged 64–75) obtained better results for BADL (p = 0.001) and IADL (p < 0.001). For physico-mental occupation, statistically significant differences were found only in IADL for mental (p = 0.034) and physical occupation (p = 0.005). Conclusions: Gender, age, and the cognitive and physical demands of occupational stages, can be important predictors of cognitive and functional impairment. These results can be generalized to other health centers in the province and to other Spanish Autonomous Communities because their socio-demographic variables are similar. It would be interesting to carry out multimodal personalized interventions that consider the factors that might affect functional impairment to preserve personal autonomy.
... Although employment can provide older persons with an opportunity for intellectual engagement, this may be dependent on the type of occupation and the mental stimulation involved (Grotz et al. 2018). In turn, intellectual engagement may be important for maintaining cognitive ability to make sound future investment and consumption decisions and detect attempts at fraud. ...
Population studies show the importance of active aging for maintaining cognitive health, but much of the research has focused on episodic memory and verbal skills. Aging and ability to make rational intertemporal financial decisions is less understood, despite its critical role in consumer finance. This study describes the relationship between age, retirement and intertemporal decision ability. A survey of adults examines the interplay of aging and retirement related to completing simple calculations with time tradeoffs in benefits. A negative association between intertemporal skills and age is indicated, with a sharp downward inflection around age 66. Regression analysis results in a significant, negative retirement‐age interaction term. This research has implications for policy and consumer decision‐making. The negative relationship of age and retirement status may suggest limits to career extension, or alternatively, that extending some types of careers could provide cognitive benefits. Further research is needed to understand the direction of causality.
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... On the other hand, a differential preservation pattern shows that, at the time of retirement, individuals with higher complexity of work exhibit higher cognitive performance than those with lower complexity of work and show reduced decline compared with those retiring from less-complex jobs. In terms of types of complexity, higher complexity of work with people has been associated with a faster rate of decline after retirement more consistently, although complexity of work with data shows similar patterns (Finkel et al., 2009;Grotz et al., 2018). Studies that applied an overall measure of complexity without differentiating between the three types of complexity (i.e., data, people, and things) found that higher-complex jobs were associated with slower cognitive aging (Fisher et al., 2014) and lower risk of cognitive impairment Boots et al., 2015) post-retirement. ...
Retirement has been associated with cognitive decline. However, the influence of specific job characteristics like occupational complexity on post-retirement cognitive outcomes is not well understood. Data from the Midlife in the United States (MIDUS) study were used to examine occupational complexity in relation to cognitive performance and cognitive change after retirement. Initial sample included 471 workers between 45 and 75 years of age. At 9-year follow-up (T2), 149 were retired and 322 were still working. All six tasks from the Brief Test of Adult Cognition by Telephone (BTACT) were used. Hierarchical regression with workers at T1 indicated that, controlling for sociodemographic variables, complexity of work with people significantly contributed to explaining variance in overall cognitive performance (1.7%) and executive function (2%). In Latent Change Score (LCS) models, complexity of work with people was the only significant predictor of cognitive change in retirees, with those retiring from high-complexity jobs showing less decline. In conclusion, high complexity of work with people is related to better executive functioning and overall cognition during working life and slower decline after retirement. The finding that more intellectually stimulating work carries cognitive advantage into retirement fits the cognitive reserve concept, where earlier intellectual stimulation brings about lower risks of cognitive problems later. Study results also go along with the unengaged lifestyle hypothesis, whereby people may slip into so-called "mental retirement," leading to post-retirement cognitive loss, which may be most apparent among those retiring from jobs with low complexity of work with people. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... A c c e p t e d M a n u s c r i p t Occupation is often a major source of a person's mentally challenging activities during adulthood; therefore the nature of work tasks during midlife may afford protections or confer risks for long-term brain health (Nexø, Meng, & Borg, 2016;Then et al., 2013). Although it is relatively well-established that engaging in cognitively stimulating activities in the workplace is associated with higher levels of cognition (Opdebeeck, Martyr, & Clare, 2016;Then et al., 2013), conflicting results have been reported in the association of mentally stimulating activities with rates of cognitive change, with some studies showing slower cognitive decline (Fisher et al., 2014;Marquié et al., 2010;Pool et al., 2016;Then et al., 2015), others reporting more rapid decline (Singh-Manoux Archana et al., 2011), and other studies showing no significant association (Gow, Avlund, & Mortensen, 2012;Grotz et al., 2017). In the current study, we investigate the rates of cognitive decline in late life associated with working in mentally challenging occupations. ...
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 to 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.
Introduction/framework/objectives
The fact that the world population, in most countries, is reaching levels of greater longevity, due to better medical care and bettergeneral living conditions, simultaneously, makes it more complicated for social security systems to obtain the necessary funds tomaintain the economic support they provide, meaning that legislation progressively extends the period within which reform can beachieved. Furthermore, the rise in the cost of living in many countries causes older individuals, sometimes already retired, to return tothe job market, in order to obtain additional funds to allow them to survive or live a little better. It is therefore pertinent to analyze howCognitive Decline may interact with work capacity and other occupational variables.
Methodology
This is a Bibliographic Review, initiated through a search carried out in April 2023 in the databases “CINALH plus with full text, Medlinewith full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database ofSystematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina andRCAAP”.
Content
Cognition can be defined as the mental process by which one perceives, remembers, speaks, thinks, makes decisions and/or solvesproblems. Cognitive Decline consists in the reduction of these capabilities, altering professional performance, not only in moreintellectual tasks, but also in those that require a certain reaction time, attention, vigilance and/or concentration.
In terms of results in this review, the authors also develop the main factors that eventually enhance, attenuate and/or are indifferent tothe emergence and/or worsening of cognitive decline.
Discussion and Conclusions
Even though there is no absolute consensus among researchers and the same situations/measures can lead to opposite effects(mitigate or worsen), institutions will be able to put into practice some of the most consensual measures to mitigate the problem, whichwill become increasingly prevalent, given the aging of the global and active population.
It would be interesting to see if there are national employers who have already looked into this topic, photographed their internalsituation, proposed an action plan in response to this and published all this data, together with the respective effectivenessassessment, sharing this in a scientific article.
Objectives
This study investigates the effects of social isolation and loneliness on cognitive function, distinguishing between the effects of transitioning into and out of these states.
Methods
This study analyzed data from 6,663 adults aged 65 or older collected over the course of 7 waves (12 years) of the Korean Longitudinal Study of Ageing from 2006 to 2018. A novel asymmetric fixed effects model was utilized to separately estimate the effects of transitions into and out of social isolation or loneliness.
Results
The association of transitions into social isolation due to a lack of informal social contact or loneliness with cognitive function (b = -1.387, p < 0.001 and b = -0.601, p < 0.001, respectively) was stronger than the association of transitions out of these states (b = 0.345, p < 0.05. and b = 0.353, p < 0.001, respectively). The magnitude of the negative and positive coefficients was statistically different (F statistic = 45.29, p < 0.001 and F statistic = 5.12, p < 0.05, respectively). In contrast, no such asymmetric effects were observed for social isolation due to a lack of formal activity (F statistic = 0.06, p = 0.800).
Discussion
The detrimental effects of transitioning into social isolation due to a lack of informal social contact (but not formal activity) or loneliness on cognitive function outweighs the beneficial effects of transitioning out of these states. Preventing the onset of social disconnection should be prioritized as an intervention to improve the cognitive function of older adults.
This study examined educational and occupational inequality as two aspects of social determinants of health that might mediate the longitudinal relationship between racialization and late life cognitive level and change. Participants were 2371 individuals racialized as Black and White from the ACTIVE study who provided occupational data. Data were analyzed from baseline and five assessments over 10-years using structural equation modeling. Black/White race served as the predictor, occupational complexity (OC) and years of education as mediators, and cognitive (memory, reasoning, and speed of processing) intercept, linear slope, and quadratic slope as the dependent variables. Black/White race showed significant indirect associations through education and OC on level of performance in cognition, linear change in reasoning and memory, and quadratic change in reasoning. Education and OC accounted for 11–16% of the association between race and cognitive level and represent modifiable social determinants of health that are associated with disparities in cognitive aging.
Organization for Economic Co-operation and Development (OECD) countries have increased the age for full retirement benefits to alleviate financial pressures. Older age is linked to higher rates of cognitive impairment. Therefore, it is crucial for public policymakers to understand the relationship between retirement timing and cognition. The purpose of this scoping review was to review the retirement timing and cognition literature and to assess possible modifying factors. A search across three databases yielded a total of 10 studies. Five studies revealed mixed findings regarding the relationship between retirement timing and cognitive decline, with reported positive, negative, and null associations. In contrast, five studies found that later retirement age reduced the risk of dementia. More cross-sectional and longitudinal studies are needed to investigate modifiable factors such as job characteristics and leisure activities to clarify the mechanisms underlying the relationship between retirement timing and cognition.
Introduction:
Subjective memory complaints (SMCs) in elderly adults could express cognitive decline in the future. A consensus has been reached about how these SMC relate to mood variables, but further research is required to determine which socio-demographic, cognitive, functional and occupational factors will act as predictors in elderly adults.
Objetive:
To analyze, through a descriptive observational study, the relationship between anxiety/depression and sex, age and occupation, with cognitive/functional performance in 367 older adults with SMC, but without objective cognitive impairment in a primary healthcare center.
Methods:
The cognitive variables were measured by applying the Spanish version of Mini-Mental State Examination (MEC-35) and Set-test for verbal fluency. To measure functional level, the Barthel index and Lawton and Brody scales were employed. Physical occupational status and mental occupational status were measured based on three levels, low, medium and high, according to the American Occupational Therapy Association.
Results:
Low educational and occupational physical and mental levels were related to anxiety and depression. In addition, differences by sex were found on anxiety and depression related to different factors. In men, anxiety was related to higher cognitive level, and in women to higher functional performance in IADLs. On the contrary, depression in men was related to lower cognitive level and higher performance in ADLs.
Conclusions:
It is important to maintain a sex-gender perspective on the study of anxiety and depression in elderly, taking into account social roles and the traints of the work environment, in order to avoid cognitive and functional impairment.
Cognitive stimulation is essential for successful aging. The influence of sex and socio-occupational elements on this area remains unknown. This study aimed to analyze the possible mediation of those elements in the effectiveness of a cognitive stimulation program in primary care. A randomized clinical trial was conducted with 232 adults aged 65 years or older without cognitive impairment. The intervention produced significant cognitive improvements. Women improved independently of social and occupational factors, while men’s improvement occurred at a low role level (zero to one), a medium level of interests (two to three), with a medium level of mental occupation (neither high nor low), and with marked personal values. The mediating variables were the intervention group in both sexes and, also in men, a low and medium role level. Therefore, the intervention and roles appear as mediating variables moderated by sex. In conclusion, cognitive stimulation programs should be adapted.
During adulthood, we spend most of our time and efforts at work. However, the impact of employment in aging is poorly explored. Our study addressed how job demands can affect aging after retirement. We have developed a descriptive observational study carried out in 367 older adults with a mean age of 73.9 years (66.5% women and 33.5% men), measuring cognition and functional status. Our results demonstrate that older adults who had high mental demands in their jobs, show better scores in cognition. However, they show poor functional development of basic and instrumental activities of daily life (p< .05). In contrast, former workers who had high physical demands, display lower scores in cognition and lower functional performance in instrumental activities (p< .05). Work life activities contribute to cognitive and physical decline after retirement. Therefore, healthy aging should include interventions that consider the job influence on the age impairment.
Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32–35), subtle cognitive impairment (SCI) (score 28–31), level deterioration (LD) (score 24–27) and moderate deterioration (MD) (score 20–23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.
RESUMO Objetivo: Revisar sistematicamente evidências dos aspectos cognitivos da pessoa idosa relacionados à aposentadoria. Métodos: A busca foi realizada em dez bases de dados: Bireme (BVS), Ebsco, Eric, Oxfford Journals, Scielo, Lilacs, PsycINFO, Scopus, ScienceDirect e Web of Science. Foram selecionados artigos de observação relacionados à cognição e à aposentadoria de pessoas com 60 anos ou mais, publicados no período de janeiro de 2010 a abril de 2020. A qualidade dos artigos foi verificada por dois revisores independentes por meio do Strengthening the Reporting of Observational Studies in Epidemiology-STROBE. Resultados: Sete estudos preencheram os critérios de inclusão, dentre os quais, quatro artigos abordaram a cognição relacionada à complexidade do trabalho; um artigo analisou a cognição a partir da relação entre trabalhadores pagos, aposentados e donas de casa; um artigo analisou a cognição de aposentados empregados e não empregados; e um artigo analisou o desempenho cognitivo em idosos observando a maneira como estes consideraram o trabalho que exerciam e sua adaptação a vida pós-aposentadoria. Considerações finais: As características do emprego são preditores importantes para a saúde mental dos trabalhadores antes e após a aposentadoria, especialmente quando se relaciona o desempenho cognitivo com a maior complexidade do trabalho com dados. ABSTRACT Objective: To review systematically the evidence of the elderly cognitive aspects related to the retirement. Methods: The search was carried out in ten databases: Bireme (BVS), Ebsco, Eric, Oxfford Journals, Scielo, Lilacs, PsycINFO, Scopus, ScienceDirect and Web of Science. Were selected observational articles related to cognition and retirement of people aged 60 and over, published between January 2010 and April 2020. The quality of the articles was verified by two independent reviewers through the Strengthening the Reporting of Observational Studies in Epidemiology guideline (STROBE). Results: Seven studies filled up the inclusion criteria among which four articles addressed cognition related to the complexity of work. An article analyzed cognition from the relationship between paid workers, retirees and housewives; an article analyzed the cognition of retirees employed and non-employed and an article analyzed the cognitive performance in the elderly, observing how they considered their work and their adaptation to post-retirement life. Final considerations: Job characteristics are important predictors for workers' mental health before and after retirement, especially when cognitive performance is related to the greater complexity of working with data.
Objetivo: Revisar sistematicamente evidências dos aspectos cognitivos da pessoa idosa relacionados à aposentadoria. Métodos: A busca foi realizada em dez bases de dados: Bireme (BVS), Ebsco, Eric, Oxfford Journals, Scielo, Lilacs, PsycINFO, Scopus, ScienceDirect e Web of Science. Foram selecionados artigos de observação relacionados à cognição e à aposentadoria de pessoas com 60 anos ou mais, publicados no período de janeiro de 2010 a abril de 2020. A qualidade dos artigos foi verificada por dois revisores independentes por meio do Strengthening the Reporting of Observational Studies in Epidemiology – STROBE. Resultados: Sete estudos preencheram os critérios de inclusão, dentre os quais, quatro artigos abordaram a cognição relacionada à complexidade do trabalho; um artigo analisou a cognição a partir da relação entre trabalhadores pagos, aposentados e donas de casa; um artigo analisou a cognição de aposentados empregados e não empregados; e um artigo analisou o desempenho cognitivo em idosos observando a maneira como estes consideraram o trabalho que exerciam e sua adaptação a vida pós-aposentadoria. Considerações finais: As características do emprego são preditores importantes para a saúde mental dos trabalhadores antes e após a aposentadoria, especialmente quando se relaciona o desempenho cognitivo com a maior complexidade do trabalho com dados.
Background:
Identifying modifiable lifestyle correlates of cognitive decline and risk of dementia is complex, particularly as few population-based longitudinal studies jointly model these interlinked processes. Recent methodological developments allow us to examine statistically defined sub-populations with separate cognitive trajectories and dementia risks.
Methods:
Engagement in social, physical, or intellectual pursuits, social network size, self-perception of feeling well understood, and degree of satisfaction with social relationships were assessed in 2854 participants from the Paquid cohort (mean baseline age 77 years) and related to incident dementia and cognitive change over 20-years of follow-up. Multivariate repeated cognitive information was exploited by defining the global cognitive functioning as the latent common factor underlying the tests. In addition, three latent homogeneous sub-populations of cognitive change and dementia were identified and contrasted according to social environment variables.
Results:
In the whole population, we found associations between increased engagement in social, physical, or intellectual pursuits and increased cognitive ability (but not decline) and decreased risk of incident dementia, and between feeling understood and slower cognitive decline. There was evidence for three sub-populations of cognitive aging: fast, medium, and no cognitive decline. The social-environment measures at baseline did not help explain the heterogeneity of cognitive decline and incident dementia diagnosis between these sub-populations.
Conclusions:
We observed a complex series of relationships between social-environment variables and cognitive decline and dementia. In the whole population, factors such as increased engagement in social, physical, or intellectual pursuits were related to a decreased risk of dementia. However, in a sub-population analysis, the social-environment variables were not linked to the heterogeneous patterns of cognitive decline and dementia risk that defined the sub-groups.
Objective:
To determine whether and how age at retirement influences the risk of dementia. The association between the age at retirement, the number of working years and the risk of dementia was evaluated over 12 years of follow-up.
Design:
A prospective population-based study.
Setting:
Three-City cohort, a French population-based study of community-dwelling individuals aged 65 to 95.
Participants:
The sample consisted of 1,658 non-demented participants at baseline.
Measurements:
All participants were evaluated at home at the initial visit and at two years interval for a period of 12 years. An active research of dementia was conducted at each follow-up; all suspected cases were analysed by an independent committee of neurologists. Information regarding retirement age and number of working years was collected at baseline using a structured questionnaire.
Results:
The multivariate Cox model, including both the age at retirement and the number of working years and adjusted for potential confounders, revealed that the risk of dementia was independently associated with the age at retirement (p=0.022) but not with the number of working years (p=0.296).
Conclusion:
Although our results are in accordance with previous studies (i.e., older age at retirement is associated with decreased risk of dementia), it provides additional information regarding the possible explanation for such results. Given that a longer working life did not reduce the risk of dementia, the age at retirement cannot be considered as a new factor of cognitive reserve but rather seems to be a psycho-social vulnerability factor. Further evidence is necessary to identify work and retirement related factors that influence the association between the age at retirement and the risk of dementia.
We examined the influence of postretirement leisure activity on longitudinal associations between work complexity in main lifetime occupation and trajectories of cognitive change before and after retirement.
Information on complexity of work with data, people, and things, leisure activity participation in older adulthood, and four cognitive factors (verbal, spatial, memory, and speed) was available from 421 individuals in the longitudinal Swedish Adoption/Twin Study of Aging. Participants were followed for an average of 14.2 years (SD = 7.1 years) and up to 23 years across eight cognitive assessments. Most of the sample (88.6%) completed at least three cognitive assessments.
Results of growth curve analyses indicated that higher complexity of work with people significantly attenuated cognitive aging in verbal skills, memory, and speed of processing controlling for age, sex, and education. When leisure activity was added, greater cognitive and physical leisure activity was associated with reduced cognitive aging in verbal skills, speed of processing, and memory (for cognitive activity only).
Engagement in cognitive or physical leisure activities in older adulthood may compensate for cognitive disadvantage potentially imposed by working in occupations that offer fewer cognitive challenges. These results may provide a platform to encourage leisure activity participation in those retiring from less complex occupations.
© The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
This paper investigates the relationship between the concept of activity (including both professional and nonprofessional) and cognitive functioning among older European individuals. In this research, we used data collected during the first wave of SHARE (Survey on Health, Ageing and Retirement in Europe), and a measurement approach known as stochastic frontier analysis, derived from the economic literature. SHARE includes a large population (n > 25,000) geographically distributed across Europe, and analyzes several dimensions simultaneously, including physical and mental health activity. The main advantages of stochastic frontier analysis are that it allows estimation of parametric function relating cognitive scores and driving factors at the boundary and disentangles frontier noise and distance to frontier components, as well as testing the effect of potential factors on these distances simultaneously. The analysis reveals that all activities are positively related to cognitive functioning in elderly people. Our results are discussed in terms of prevention of cognitive aging and Alzheimer's disease, and regarding the potential impact that some retirement programs might have on cognitive functioning in individuals across Europe.
We investigate the relationship between aging, cognitive abilities and retirement using the Survey on Health, Aging and Retirement in Europe (SHARE), a household panel that offers the possibility of comparing several European countries using nationally representative samples of the population aged 50+. We use a version of the model proposed by Grossman (1972) as a guide for our empirical specification of the age-profile of cognitive abilities. According to the model, retirement plays a fundamental role in explaining the process of cognitive deterioration. Our empirical results confirm this key prediction. They also indicate that education plays a fundamental role in explaining heterogeneity in the level of cognitive abilities.
We used data from SWEOLD, a Swedish nationally representative study of individuals aged 77 years or older, to examine midlife indicators of job strain in relation to cognitive performance and impairment.
In all, 827 participants completed an abridged 11-point version of the Mini-Mental State Examination in-person in 1992 and/or 2002 and had self-reported and/or occupation-based scores for job control and demands from data collected in 1968. Seventeen percent scored below the cutoff for cognitive impairment.
Controlling for age, sex, education, self-rated health, and year of cognitive screening, low self-reported and occupation-based job control at midlife was associated with poorer cognitive performance later (ps < .001). For the occupation-based measure, low job control was also associated with greater likelihood of impairment, whereas having an active job (high job control/high job demands) was associated with better cognitive performance and lower likelihood of impairment (ps < .01). Childhood environment, midlife depressive symptoms, and social activity had limited influence, whereas the influence of both adulthood socioeconomic position and work complexity on these results was more pronounced.
Job control at midlife, by itself and in combination with job demands, may influence cognitive functioning later above and beyond demographic variables and other occupational characteristics.
Some studies suggest that people can maintain their cognitive abilities through "mental exercise." This has not been unequivocally proven. Retirement is associated with a large change in a person's daily routine and environment. In this paper, we propose two mechanisms how retirement may lead to cognitive decline. For many people retirement leads to a less stimulating daily environment. In addition, the prospect of retirement reduces the incentive to engage in mentally stimulating activities on the job. We investigate the effect of retirement on cognition empirically using cross-nationally comparable surveys of older persons in the United States, England, and 11 European countries in 2004. We find that early retirement has a significant negative impact on the cognitive ability of people in their early 60s that is both quantitatively important and causal. Identification is achieved using national pension policies as instruments for endogenous retirement.
We examined the association between complexity of the main lifetime occupation and changes in cognitive ability in later life. Data on complexity of work with data, people, and things and on 4 cognitive factors (verbal, spatial, memory, and speed) were available from 462 individuals in the longitudinal Swedish Adoption/Twin Study of Aging. Mean age at the first measurement wave was 64.3 years (SD = 7.2), and 65% of the sample had participated in at least three waves of data collection. Occupational complexity with people and data were both correlated with cognitive performance. Individuals with more complex work demonstrated higher mean performance on the verbal, spatial, and speed factors. Latent growth curve analyses indicated that, after correcting for education, only complexity with people was associated with differences in cognitive performance and rate of cognitive change. Continued engagement as a result of occupational complexity with people helped to facilitate verbal function before retirement, whereas a previous high level of complexity of work with people was associated with faster decline after retirement on the spatial factor.
Enhanced cued recall provides a simple and clinically useful memory test for identifying dementia in the elderly. Because this test induces semantic processing and coordinates encoding and retrieval for maximum recall, genuine memory deficits due to impairment of specific memory processes can be distinguished from apparent memory deficits due to use of inefficient strategies or impairment of other cognitive processes. Since genuine memory deficits in the elderly are usually associated with dementia, their identification is highly predictive of clinical dementia. The present study validates the use of enhanced cued recall as a screening test for dementia in 70 aged subjects. All but one person with a pure amnesia were correctly classified. Enhanced cued recall correctly classified 97% of the 120 subjects in this and the previous study. Enhanced cued recall shows learning not revealed by free recall, providing more accurate measurement of memory, and distinguishes demented from nondemented elderly more accurately than either free recall or recognition.
The idea of reserve against brain damage stems from the repeated observation that there does not appear to be a direct relationship between the degree of brain pathology or brain damage and the clinical manifestation of that damage. This paper attempts to develop a coherent theoretical account of reserve. One convenient subdivision of reserve models revolves around whether they envision reserve as a passive process, such as in brain reserve or threshold, or see the brain as actively attempting to cope with or compensate for pathology, as in cognitive reserve. Cognitive reserve may be based on more efficient utilization of brain networks or of enhanced ability to recruit alternate brain networks as needed. A distinction is suggested between reserve, the ability to optimize or maximize normal performance, and compensation, an attempt to maximize performance in the face of brain damage by using brain structures or networks not engaged when the brain is not damaged. Epidemiologic and imaging data that help to develop and support the concept of reserve are presented.
We examined the association between risk of dementia or Alzheimer's disease (AD) and occupation by using measures of complexity
of work with data, people, and things. The study included 10,079 members of the population-based Swedish Twin Registry who
were participants in the HARMONY study. We diagnosed dementia by means of a two-stage procedure—cognitive impairment screening
followed by full clinical evaluation. We analyzed data with case-control and cotwin control designs. The cotwin control design
provides control over genetic and familial factors. In the case-control study, controlling for age, gender, and level of education,
we found that more complex work with people was associated with reduced risk of AD. Greater complexity of work with people
and data was protective in twin pairs discordant for AD. Findings suggest that greater complexity of work, and particularly
complex work with people, may reduce the risk of AD.
Objectives: The authors explored the association between complexity of primary lifetime occupation and cognition in older adulthood. Method: The study included 386 participants from the Swedish Panel Study of Living Conditions of the Oldest Old, a nationally representative sample aged 77 years or older. The authors examined complexity of work with data, people, and things in relation to cognitive functioning, measured with a shortened version of Mini-Mental State Examination (MMSE) and cognitive impairment based on MMSE score cutoff. Results: Complexity of work with data and people were associated with better MMSE scores, controlling for age, sex, childhood socioeconomic status, and education. The association between complexity of work with data and MMSE remained statistically significant when adult occupational status was substituted for education as a covariate. Discussion: Complexity of primary lifetime occupation may be reflected in cognitive functioning even in advanced old age. This effect may be independent of education or occupational status.
The authors evaluated the association of complexity of work with data, people, and things with the incidence of dementia, Alzheimer's disease, and vascular dementia in the Canadian Study of Health and Aging, while adjusting for work-related physical activity. The Canadian Study of Health and Aging is a 10-year population study, from 1991 to 2001, of a representative sample of persons aged 65 years or older. Lifetime job history allowed application of complexity scores and classification of work-related physical activity. Analyses included 3,557 subjects, of whom 400 were incident dementia cases, including 299 with Alzheimer's disease and 93 with vascular dementia. In fully adjusted Cox regression models, high complexity of work with people or things reduced risk of dementia (hazard ratios were 0.66 (95% confidence interval: 0.44, 0.98) and 0.72 (95% confidence interval: 0.52, 0.99), respectively) but not Alzheimer's disease. For vascular dementia, hazard ratios were 0.36 (95% confidence interval: 0.15, 0.90) for high complexity of work with people and 0.50 (95% confidence interval: 0.25, 1.00) for high complexity of work with things. Subgroup analyses according to median duration (23 years) of principal occupation showed that associations with complexity varied according to duration of employment. High complexity of work appears to be associated with risk of dementia, but effects may vary according to subtype.
Objective:
To investigate the relationship between psychological transition and adjustment to retirement and cognitive performances in older adults.
Methods:
The study's sample was taken from the Approche Multidisciplinaire Intégrée cohort, a French prospective study of retirees from agriculture, aged 65 and over, living in rural settings in southwestern France. The cross-sectional analyses were conducted on a sample of 590 elderly people without dementia at baseline and for whom information on perception of the work setting, experience of the retirement transition and adaptation to retirement life (nine variables) as well as neuropsychological measures (global cognitive functioning, episodic memory, verbal fluency, attention and psychomotor speed) were available at first visit.
Results:
Multivariable linear regression analyses, including nine variables related to retirement and adjusted for potential confounding factors, indicated that three of them - positive consideration of former work situation, development of new activities during retirement and good adaptation to free time - were associated with better cognitive performances.
Conclusions:
We found that several factors proved to be determinants of good cognitive functioning at retirement and could serve as a basis for the development of more efficient intervention programs aimed at helping retirees to maintain good cognitive functioning after retirement.
With an ever increasing population of aging people in the western world, it is more crucial than ever that we try to understand how and why cognitive competence breaks down with advancing age why do some people follow normal patterns of cognitive change, while others follow a path of progressive decline, with neurodegenerative diseases such as Alzheimer's. What can be done to prevent cognitive decline or - to avoid neurodegenerative diseases? The answers, if they come, will not emerge from research within one discipline, but from work being done across a range of scientific and medical specialities. This book delves into the subjects of cognitive aging, neuroscience, pharmacology, health, genetics, sensory biology, and epidemiology. This book is about new frontiers rather than past research and accomplishments. Recently cognitive aging research has taken several new directions, linking with, and benefiting from, rapid technological and theoretical advances in these neighbouring disciplines. This book provides unique interdisciplinary coverage of the topic. © Roger A. Dixon, Lars Bäckman, and Lars Göran-Nilsson 2004. All rights reserved.
The recent availability of longitudinal data on the possible association of different lifestyles with dementia and Alzheimer's disease (AD) allow some preliminary conclusions on this topic. This review systematically analyses the published longitudinal studies exploring the effect of social network, physical leisure, and non-physical activity on cognition and dementia and then summarises the current evidence taking into account the limitations of the studies and the biological plausibility. For all three lifestyle components (social, mental, and physical), a beneficial effect on cognition and a protective effect against dementia are suggested. The three components seem to have common pathways, rather than specific mechanisms, which might converge within three major aetiological hypotheses for dementia and AD: the cognitive reserve hypothesis, the vascular hypothesis, and the stress hypothesis. Taking into account the accumulated evidence and the biological plausibility of these hypotheses, we conclude that an active and socially integrated lifestyle in late life protects against dementia and AD. Further research is necessary to better define the mechanisms of these associations and better delineate preventive and therapeutic strategies.
Objective: To describe the baseline characteristics of the participants in the Three-City (3C) Study, a study aiming to evaluate the risk of dementia and cognitive impairment attributable to vascular factors. Methods: Between 1999 and 2001, 9,693 persons aged 65 years and over, institutionalized, were recruited from the electoral rolls of three French cities, i.e. Bordeaux, Dijon and Montpellier. Health-related data were collected during face-to-face interviews using standardized questionnaires. The baseline examination included cognitive testing and diagnosis of dementia, and assessment of vascular risk factors, including blood pressure measurements, ultrasound examination of the carotid arteries, and measurement of biological parameters (glycemia, total, high-density lipoprotein and low-density lipoprotein cholesterol, triglycerides, creatinemia); 3,442 magnetic resonance imaging (MRI) examinations were performed in subjects aged 65-79. Measurements of ultrasound, blood, and MRI parameters were centralized. Two follow-up examinations (at 2 and 4 years) were planned. Results: After exclusion of the participants who had subsequently refused the medical interview, the 3C Study sample consisted of 3,649 men (39.3%) and 5,645 women, mean age 74.4 years, with a relatively high level of education and income. Forty-two percent of the participants reported to be followed up for hypertension, about one third for hypercholesterolemia, and 8% for diabetes; 65% had elevated blood pressure measures (systolic blood pressure greater than or equal to 140 or diastolic blood pressure greater than or equal to 90). The proportion of Mini-Mental State Examination scores below 24 was 7% and dementia was diagnosed in 2.2% of the participants. Conclusion: Distribution of baseline characteristics of the 3C Study participants suggests that this study will provide a unique opportunity to estimate the risk of dementia attributable to vascular factors. Copyright (C) 2003 S. Karger AG, Basel.
To examine associations between complexity of main lifetime occupation and cognitive performance in later life.
Occupational complexity ratings for data, people, and things were collected from the Dictionary of Occupational Titles for 1,066 individuals (men = 534, women = 532) in the Lothian Birth Cohort 1936. IQ data were available from mean age 11 years. Cognitive ability data across the domains of general ability, processing speed, and memory were available at mean age 70 years.
General linear model analyses indicated that complexity of work with people and data were associated with better cognitive performance at age 70, after including age 11 IQ, years of education, and social deprivation.
The current findings are supportive of the differential preservation hypotheses that more stimulating environments preserve cognitive ability in later life, although the continued effects into old age are still debated. Studies that have early-life cognitive ability measures are rare, and the current study offers interesting prospects for future research that may further the understanding of successful aging.
© 2014 American Academy of Neurology.
This paper analyses the effect of retirement on cognitive functioning using a longitudinal survey among older Americans, which allows controlling for individual heterogeneity and endogeneity of the retirement decision by using the eligibility age for social security as an instrument. The results highlight a significant negative effect of retirement on cognitive functioning. Our findings suggest that reforms aimed at promoting labour force participation at an older age may not only ensure the sustainability of social security systems but may also create positive health externalities for older individuals.
SYNOPSIS
As part of a 5-year, prospective, epidemiological survey of normal and pathological ageing, this cross-sectional analysis examines the relationship between depressive symptomatology (CES-D) and cognitive functioning (MMS) in a community sample of 2792 non-institutionalized persons (age ≥ 65) living in Southwest France. Of the sample, 13·4%, report depressive symptoms above the cut-off. A significant association was found between CES-D and MMS scores, but after adjusting for age, living arrangements, and especially functional limitations, the relationship remained strong only for women.
The Set test, a simple rapid test of mental function, was applied to a sample of 189 elderly subjects. A score of under 15 on the test corresponded closely to a clinical diagnosis of dementia. Scores in the range 15 to 24 showed a lesser degree of association with dementia; while no subject with a score of 25 or over was demented. Low scores in the test were associated with physical illness, and to a limited extent with low social class, but not with affective illness. The test appears worthy of further studies in screening programs, and may have other clinical and epidemiological uses.
Little is known about whether persons with mentally demanding jobs are protected against cognitive impairment and whether this association is independent of intellectual abilities and other confounders. Longitudinal data from the Maastricht Aging Study (MAAS) were used to examine this association. After the 1993-1995 baseline examination, there was a first 3-year follow-up examination (1996-1998) among 630 men and women, aged 50 to 80, who exhibited no cognitive impairment at baseline. Persons with mentally demanding jobs had lower risks of developing cognitive impairment during follow-up (36 cases), compared with persons without such jobs (odds ratio = 0.79; 95% confidence interval: 0.65-0.96). About 1.5% of the persons with high mental work demands developed impairment compared to 4% of the persons with few work demands. The protective effect was independent of intellectual abilities and other confounders. Our findings provide evidence that continued and potentially modifiable mental stimulation during adult life may protect men and women against cognitive impairment.
Clinical and pathological data from the Rush Memory and Aging Project were used to test the hypothesis that distress proneness is associated with increased risk of Alzheimer's disease (AD). More than 600 older persons without dementia completed a 6-item measure of neuroticism, a stable indicator of proneness to psychological distress. At annual intervals thereafter, they underwent uniform evaluations that included clinical classification of AD and administration of 18 cognitive tests. Those who died underwent brain autopsy from which composite measures of AD pathology were derived. During a mean of about 3 years of follow-up, 55 people were clinically diagnosed with AD. In analyses that controlled for age, sex, and education, persons with a high level of distress proneness (score = 24, 90th percentile) were 2.7 times more likely to develop AD than those not prone to distress (score = 6, 10th percentile). Adjustment for depressive symptomatology or frequency of cognitive, social, and physical activity did not substantially change this effect. Distress proneness was also associated with more rapid cognitive decline. Among 45 participants who died and underwent brain autopsy, distress proneness was unrelated to diverse measures of AD pathology and was inversely related to cognition after controlling for AD pathology. The results support the hypothesis that distress proneness is associated with increased risk of dementia and suggest that neurobiologic mechanisms other than AD pathology may underlie the association.
To examine the effect of occupational characteristics on cognitive status change in members of the NAS-NRC Twins Registry of World War II veterans.
Participants completed the modified Telephone Interview for Cognitive Status (TICS-m) on three occasions spanning a period of approximately 7 years. Based on factor analysis, occupational characteristics were interpreted as reflecting general intellectual demands (GI), human interaction and communication (HC), physical exertion (PE), and visual attention (VA).
Based on regression analysis of TICS-m change that was dependent on twin pairing and additionally covarying for education, age at each testing event, medical conditions, and initial TICS-m score, higher GI was associated with a modest longitudinal improvement in TICS-m performance, whereas higher PE and VA were both associated with a modest decline. Subsequent analysis revealed that these significant effects were present among dizygotic twins, but not among monozygotic twins.
Previous findings of a relationship between occupational characteristics and cognitive performance in later life may be partially explained by genetic factors; however, until these genes are identified, occupational characteristics may be useful markers.
Cognition is not directly measurable. It is assessed using psychometric tests, which can be viewed as quantitative measures of cognition with error. The aim of this article is to propose a model to describe the evolution in continuous time of unobserved cognition in the elderly and assess the impact of covariates directly on it. The latent cognitive process is defined using a linear mixed model including a Brownian motion and time-dependent covariates. The observed psychometric tests are considered as the results of parameterized nonlinear transformations of the latent cognitive process at discrete occasions. Estimation of the parameters contained both in the transformations and in the linear mixed model is achieved by maximizing the observed likelihood and graphical methods are performed to assess the goodness of fit of the model. The method is applied to data from PAQUID, a French prospective cohort study of ageing.
To examine the association of job characteristics and intelligence to cognitive status in members of the National Academy of Sciences-National Research Council Twins Registry of World War II veterans.
Participants (n = 1,036) included individuals with an assessment of intelligence based on Armed Services testing in early adulthood. In late adulthood, these individuals completed the modified Telephone Interview for Cognitive Status (TICS-m) and occupational history as part of an epidemiologic study of aging and dementia. Occupational history was coded to produce a matrix of job characteristics. Based on factor analysis, job characteristics were interpreted as reflecting general intellectual demands (GI), human interaction and communication (HC), physical activity (PA), and visual attention (VA).
Based on regression analysis of TICS-m score covarying for age, intelligence, and years of education, higher levels of GI and HC were independently associated with higher TICS-m performance, whereas higher PA was independently associated with lower performance. There was an interaction of GI and intelligence, indicating that individuals at the lower range of intellectual aptitude in early adulthood derived greater cognitive benefit from intellectually demanding work.
Intellectually demanding work was associated with greater benefit to cognitive performance in later life independent of related factors like education and intelligence. The fact that individuals with lower intellectual aptitude demonstrated a stronger positive association between work and higher cognitive performance during retirement suggests that behavior may enhance intellectual reserve, perhaps even years after peak intellectual activity.
Manuel Pour l'Application du Test de Rétention Visuelle
- A Benton
Benton A. Manuel Pour l'Application du Test de Rétention
Visuelle. Applications Cliniques et Expérimentales, 2nd edition. Paris: Centre de Psychologie Appliquée, 1965.
Ageing, cognitive abilities and retirement
- F Mazzonna
- F Peracchi