Open AccessLongitudinal association between lifetime workforce participation and risk of self-reported cognitive decline in community-dwelling older adults
Author(s) -
Kimiko Tomioka,
Norio Kurumatani,
Keigo Saeki
Publication year - 2020
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0234392
Subject(s) - demography , poisson regression , gerontology , confidence interval , medicine , cumulative incidence , health and retirement study , cognitive decline , geriatric depression scale , workforce , incidence (geometry) , longitudinal study , psychology , cognition , cohort , population , dementia , psychiatry , disease , pathology , depressive symptoms , physics , sociology , optics , economics , economic growth
Background Although many governments are promoting workforce participation (WP) by older people, evidence of WP’s effects on active aging is inadequate. We examined whether there is a gender-specific beneficial effect of lifetime WP from adulthood though old age against self-reported cognitive decline (CD) among community-dwelling older adults. Methods We used data from a community-based prospective study of 2,422 men and 2,852 women aged ≥65 with neither poor cognition nor disability in basic activities of daily living at baseline. Self-reported CD was measured using the Cognitive Performance Scale. Lifetime WP evaluated the presence or absence of WP at baseline, the longest-held occupation, and lifetime working years (total working years throughout lifetime). Generalized estimating equations of the multivariable Poisson regression model were applied to evaluate a cumulative incidence ratio (CIR) for self-reported CD and a 95% confidence interval (CI), controlled for age, education, self-perceived economic status, chronic medical conditions, smoking history, physical activity, depression, and instrumental activities of daily living. To examine any gender-specific association, stratified analyses by gender were performed. Results The 33-month cumulative incidence of self-reported CD was 15.7% in men and 14.4% in women. After covariate adjustments and mutual adjustment for three items of lifetime WP, men who had their longest held job in a white-collar occupation reported significantly decreased self-reported CD compared to men engaged in blue-collar jobs (CIR 0.72; 95% CI, 0.57–0.91), and women had a significant dose–response relationship between longer lifetime working years and less decline in subjective cognitive functioning ( P for trend <0.029). Among both genders, WP at baseline was not associated with self-reported CD. Conclusions Our results suggest that lifetime WP, especially lifetime principal occupation in men and lifetime working years in women, may play a more prominent role in preventing self-reported CD than later-life WP.