LIFECOURSE WORK-FAMILY DEMANDS AND LATE-LIFE MEMORY DECLINE AMONG U.S. WOMEN

Abstract

Throughout the twentieth century, lifecourse patterns of employment, marriage, and child rearing changed drastically for U.S. women. Most prior lifecourse studies are limited to experiences at one or a few points in the lifecourse. Sequence analysis simultaneously accounts for order, timing, and duration of lifecourse exposures. We examined whether lifecourse work-family demands predicted late-life rate of memory decline among U.S. women. We used data from women born 1935–1956 in the Health and Retirement Study, a national cohort study (N=6,386). Participants reported employment, marital, and parenthood statuses at every age between 16 and 50 years. Sequence analysis was used to collapse work-family trajectories into clustered sequences. Composite memory (z-scored) was assessed biennially from 1995–2016 using immediate and delayed word list recall or the Informant Questionnaire for Cognitive Decline. To examine whether work-life sequences predicted late-life memory decline, we used linear mixed effects models (with age as the timescale and linear splines with a knot at 65 years) adjusted for practice effects, enrollment age, race/ethnicity, birth region, childhood socioeconomic status index, and educational attainment. Mean enrollment age was 55.2 years (range 50-74). Mean follow-up was 13.8 years. Work-family sequences included working non-mothers (n=518), working married mothers (n=4,450), working single mothers (n=545), non-working married mothers (n=541), and non-working single mothers (n=332). Rate of memory decline was similar for working non-mothers and working mothers. Rate of memory decline was fastest among non-working women. For example, compared with working married mothers, non-working single mothers and non-working married mothers declined 0.26 and 0.29 more standardized units between ages 65–75 years, respectively. Rate of memory decline was slightly faster in working single mothers than working married mothers at ages 50–65 years, but not at older ages (Figure). Women who worked, including mothers and non-mothers, experienced the best rates of late-life memory decline, suggesting work may play a stronger role in late-life memory decline than family structure; however, unmeasured confounding cannot be ruled out. If causal, the current findings suggest that policies that help women with children to stay in the workforce could be an effective population-level strategy to prevent memory decline in women.