Abstract
BackgroundGrowing evidence suggests a role of occupation in the emergence and manifestation of dementia. Occupations are often defined by complexity level, although working environments and activities differ in several other important ways. We aimed to capture the multi-faceted nature of occupation through its measurement as a qualitative (instead of a quantitative) variable and explored its relationship with different types of dementia.MethodsWe collected occupational information of 2121 dementia patients with various suspected etiologies from the Amsterdam Dementia Cohort (age 67 ± 8, 57% male; MMSE 21 ± 5). Our final sample included individuals with Alzheimer’s disease (AD) dementia (n = 1467), frontotemporal dementia (n = 281), vascular dementia (n = 98), Lewy body disease (n = 174), and progressive supranuclear palsy/corticobasal degeneration (n = 101). Within the AD group, we used neuropsychological data to further characterize patients by clinical phenotypes. All participants were categorized into 1 of 11 occupational classes, across which we evaluated the distribution of dementia (sub)types with χ2 analyses. We gained further insight into occupation-dementia relationships through post hoc logistic regressions that included various demographic and health characteristics as explanatory variables.ResultsThere were significant differences in the distribution of dementia types across occupation groups (χ2 = 85.87, p < .001). Vascular dementia was relatively common in the Transportation/Logistics sector, and higher vascular risk factors partly explained this relationship. AD occurred less in Transportation/Logistics and more in Health Care/Welfare occupations, which related to a higher/lower percentage of males. We found no relationships between occupational classes and clinical phenotypes of AD (χ2 = 53.65, n.s.).ConclusionsRelationships between occupation and dementia seem to exist beyond the complexity level, which offers new opportunities for disease prevention and improvement of occupational health policy.
Highlights
Growing evidence suggests a role of occupation in the emergence and manifestation of dementia
The results indicate that older individuals who Loenhoud et al Alzheimer's Research & Therapy (2019) 11:112 engaged in greater levels of occupational complexity have a better current cognitive status [6,7,8,9,10,11,12,13], a lower risk to develop dementia [5, 14,15,16,17], or a different rate of clinical progression after the onset of dementia [4, 11, 18]
Individuals with frontotemporal dementia (FTD) were younger compared to other groups (63 ± 7), and Lewy body disease (DLB) participants were significantly older than the Alzheimer’s disease (AD) group (69 ± 7)
Summary
Growing evidence suggests a role of occupation in the emergence and manifestation of dementia. The results indicate that older individuals who Loenhoud et al Alzheimer's Research & Therapy (2019) 11:112 engaged in greater levels of occupational complexity have a better current cognitive status [6,7,8,9,10,11,12,13], a lower risk to develop dementia [5, 14,15,16,17], or a different rate of clinical progression after the onset of dementia [4, 11, 18] These studies mostly investigated one particular form of dementia, or “dementia” in general without specifying its type. A broader evaluation of occupation in the context of dementia could provide important new insights in the context of dementia, this approach is relatively rare
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