Keeping People with Dementia or Mild Cognitive Impairment in Employment: A Literature Review on Its Determinants.

Fabiola Silvaggi,Alberto Raggi,Matilde Leonardi,Pietro Tiraboschi,Cristina Muscio,Claudia Toppo

doi:10.3390/ijerph17030842

Abstract

Background: Approximately 10–20% of people with early onset dementias (EOD) or mild cognitive impairment (MCI) are aged under 65 and, due to extended working life and increasing prevalence of dementias, they more and more frequently will be present in the active workforce. This review aimed to synthesize the available information about the ability of people with EOD or MCI to retain their participation in the labor workforce. Methods: We searched SCOPUS and EMBASE for peer-reviewed papers that reported studies assessing work ability in employees with EOD or MCI that were published in the period of January 2010 to August 2019. Results: We selected four publications, in which 1012 participants with EOD or MCI were enrolled (41.2% males). Cognitive difficulties rather than motor dysfunction were found to reduce patients’ ability to work. Two main themes emerged: management of dementia in the workplace and the impact of symptoms on working status. Conclusions: EOD and MCI impact on workforce participation by determining problems in executive functions. Although this review was based on a small sample of studies, it can be shown that support in the workplace may act as a facilitator to enhance workforce participation, and occupational health professionals can help patients with EOD or MCI continue working as much as possible.

Highlights

Dementia is a broad term referring to a number of neurological disorders that cause a progressive decline in cognitive functioning [1] and can be associated with several neurological conditions, such as Parkinson’s disease (PD), Huntington’s disease (HD), Alzheimer’s disease (AD) and AD-related disorder (ADRD), Lewy bodies dementia (LBD), frontotemporal dementia (FTD), or vascular conditions [2].The vast majority of dementia cases are diagnosed among people aged 70 or older, and few are diagnosed in adulthood, that is, before the age of 65—these conditions are referred to as early-onset dementia (EOD)
Dementia can be preceded by mild cognitive impairment (MCI), whose prevalence is 3–22% in people aged 65 or older and can be diagnosed before aged 65 in a portion of the population wherein it progresses into dementia in 5–10% of cases per year [7]
Available information on work ability was descriptively reported and we relied on a bottom-up approach for the organization of review’s results, that is, we described literature findings consistently with the way in which results were reported in each paper

Summary

Introduction

The vast majority of dementia cases are diagnosed among people aged 70 or older, and few are diagnosed in adulthood, that is, before the age of 65—these conditions are referred to as early-onset dementia (EOD). Dementia can be preceded by mild cognitive impairment (MCI), whose prevalence is 3–22% in people aged 65 or older and can be diagnosed before aged 65 in a portion of the population wherein it progresses into dementia in 5–10% of cases per year [7]. 10–20% of people with early onset dementias (EOD) or mild cognitive impairment (MCI) are aged under 65 and, due to extended working life and increasing prevalence of dementias, they more and more frequently will be present in the active workforce. Two main themes emerged: management of dementia in the workplace and the impact of symptoms on working status

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