Subjective cognitive complaints and permanent work disability: a prospective cohort study

• Published in: International archives of occupational and environmental health 2021-07, Vol.94 (5), p.901-910
• Main Authors: Pihlajamäki, Minna, Arola, Heikki, Ahveninen, Heini, Ollikainen, Jyrki, Korhonen, Mikko, Nummi, Tapio, Uitti, Jukka, Taimela, Simo
• Format: Article
• Language: English
• Subjects: Cognitive ability; Cognitive tasks; Cohort analysis; Confidence intervals; Decision making; Earth and Environmental Science; Employees; Environment; Environmental Health; Females; Males; Occupational Medicine/Industrial Medicine; Occupations; Original; Original Article; Questionnaires; Rehabilitation
• ISSN: 0340-0131; 1432-1246
• DOI: 10.1007/s00420-020-01643-1

Purpose Work disability (WD) is a medico-legal concept that refers to disability benefits (DB) granted due to diseases. We assessed whether subjective cognitive complaints (SCC)—presenting as self-rated difficulties of concentration, memory, clear thinking, and decision making—predict permanent WD in knowledge-intensive occupations. Methods In this prospective cohort study with up to 7-year follow-up, we combined the SCC questionnaire results with reliable registry data on the DBs of 7161 professional/managerial employees (46% females). We excluded employees who were on long-term sickness absence (SA) or had received a DB at baseline. The exposure variable was the presence of SCC. Age and SA before the questionnaire as a proxy measure of general health were treated as confounders and the analyses were conducted by gender. The outcome variable was a granted DB. The cumulative incidence function illustrates the difference between SCC categories, and the Fine-Gray model estimates the predictors of WD during the 8-year follow-up. Results The annual incidence of DB was 0.15% in the entire cohort: 0.18% among the females, and 0.12% among the males ( p  = 0.795). The most common primary reasons for permanent WD were mental (36%) and musculoskeletal (20%) disorders. SCC predicted DB in both genders when controlling for age and prior SA. Hazard ratios were 2.9 with a 95% confidence interval 1.4–6.0 for the females and 3.7 (1.8–7.9) for the males. Conclusion Subjective cognitive complaints predict permanent WD in knowledge-intensive occupations. This finding has implications for supporting work ability and preventing work disability among employees with cognitively demanding tasks.