Longitudinal association between lifetime workforce participation and risk of self-reported cognitive decline in community-dwelling older adults

• Published in: PloS one 2020-06, Vol.15 (6), p.e0234392-e0234392
• Main Authors: Tomioka, Kimiko, Kurumatani, Norio, Saeki, Keigo
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adults; Aged; Aged, 80 and over; Aging; Aging - psychology; Biology and Life Sciences; Cognition; Cognitive ability; Cognitive Dysfunction - epidemiology; Confidence intervals; Depression (Mood disorder); Disabilities; Elderly workers; Employment - psychology; Employment - statistics & numerical data; Exercise; Female; Gender; Gender differences; Geriatric cognitive disorders; Health aspects; Humans; Incidence; Independent Living - psychology; Japan - epidemiology; Labor force; Male; Medicine and Health Sciences; Men; Nursing care; Occupations; Occupations - statistics & numerical data; Older people; People and Places; Performance evaluation; Physical activity; Prospective Studies; Psychological aspects; Regression analysis; Regression models; Risk Factors; Self Report; Service life assessment; Social Sciences; Statistical analysis; Studies; Surveys; Time Factors; Women; Workforce
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0234392

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. 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. 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