Work‐Related Stress May Increase the Risk of Vascular Dementia

• Published in: Journal of the American Geriatrics Society (JAGS) 2012-01, Vol.60 (1), p.60-67
• Main Authors: Andel, Ross, Crowe, Michael, Hahn, Elizabeth A., Mortimer, James A., Pedersen, Nancy L., Fratiglioni, Laura, Johansson, Boo, Gatz, Margaret
• Format: Article
• Language: English
• Subjects: Age; Age Factors; Aged; Aged, 80 and over; Alzheimer's disease; Biological and medical sciences; Cognitive ability; Dementia; Dementia disorders; Dementia, Vascular - epidemiology; Dementia, Vascular - etiology; Diseases in Twins; Education; Female; General aspects; Geriatric Assessment - methods; Geriatrics; Humans; Incidence; job strain; Male; Mathematical models; Medical sciences; Medicin och hälsovetenskap; Miscellaneous; Neurodegenerative diseases; Neurology; Occupational Diseases - complications; Occupational Diseases - epidemiology; Occupational Exposure - adverse effects; Occupational health; Occupational stress; Population studies; Psychology; Psykologi; Public health. Hygiene; Public health. Hygiene-occupational medicine; Registries; Risk Assessment - methods; Risk Factors; Sex; Social interactions; Stress; Stress, Psychological - complications; Stress, Psychological - epidemiology; Surveys and Questionnaires; Sweden - epidemiology; Twins; vascular dementia; Vascular diseases; Vascular diseases and vascular malformations of the nervous system; work-related stress
• ISSN: 0002-8614; 1532-5415; 1532-5415
• DOI: 10.1111/j.1532-5415.2011.03777.x

Objectives To examine job control, job demands, social support at work, and job strain (ratio of demands to control) in relation to risk of any dementia, Alzheimer's disease (AD), and vascular dementia (VaD). Design Cohort study. Setting The population‐based Study of Dementia in Swedish Twins. Participants Two hundred fifty‐seven people with dementia (167 AD, 46 VaD) and 9,849 without. Measurements Dementia diagnoses were based on telephone screening for cognitive impairment followed by in‐person clinical examination. An established job exposure matrix was matched to main occupation categories to measure work characteristics. Results In generalized estimating equations (adjusted for the inclusion of complete twin pairs), lower job control was associated with greater risk of any dementia (odds ratio (OR) = 1.17, 95% confidence interval (CI) = 1.04–1.31) and VaD specifically (OR = 1.39, 95% CI = 1.07–1.81). Lower social support at work was associated with greater risk of dementia (OR = 1.15, 95% CI = 1.03–1.28), AD (OR = 1.14, 95% CI = 1.00–1.31), and VaD (OR = 1.28, 95% CI = 1.02–1.60). Greater job strain was associated with greater risk of VaD only (OR = 1.28, 95% CI = 1.02–1.60), especially in combination with low social support (OR = 1.35, 95% CI = 1.11–1.64). Age, sex, and education were controlled for. Work complexity, manual work, and vascular disease did not explain the results. No differences in work‐related stress scores were observed in the 54 twin pairs discordant for dementia, although only two pairs included a twin with VaD. Conclusion Work‐related stress, including low job control and low social support at work, may increase the risk of dementia, particularly VaD. Modification to work environment, including attention to social context and provision of meaningful roles for employees, may contribute to efforts to promote cognitive health.