Racial and Ethnic Differences in Occupational Complexity and Late‐Life Cognition

Abstract

AbstractBackgroundStructural racism affects employment opportunities, resulting in occupational segregation and potential racial and ethnic health disparities. Research examining the association between occupational complexity and late‐life cognition within and across racial and ethnic groups is limited. We aim to address this research gap using the Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) cohort of Asian, Black, Latino and White community‐dwelling participants aged 65+ years.MethodsWe linked occupational complexity scores (from the Dictionary of Occupational Titles) for data (range: 0‐6), people (0‐8), and things (0‐7) to self‐reported main lifetime occupation. We assessed baseline domain‐specific cognition (executive functioning, verbal episodic memory, and semantic memory) using the Spanish and English Neuropsychological Assessment Scales. Using linear regression models, we estimated associations between each occupational complexity measure and domain‐specific z‐scores, adjusting for age, sex, race and ethnicity, and education. We also assessed effect modification by race and ethnicity.ResultsAmong 1,548 participants (mean age = 76 years), 24% identified as Asian, 27% as Black, 19% as Latino, 29% as White, and 50% had a college degree or higher (Table 1). Occupational complexity with data and people varied across race and ethnicity (p‐value: >0.001 and 0.016, respectively), but not for complexity with things. Greater occupational complexity with data was associated with higher executive function (β = 0.05 SD units; 95% CI:0.02‐0.09), semantic memory (0.07 SD units; 95% CI:0.04‐0.11) and verbal episodic memory (0.06 SD units; 95% CI:0.02‐0.10) (Figure 1). Complexity with people was associated with higher executive function and semantic memory only. Complexity with things was not associated with any cognitive domain. Effect modification by race and ethnicity was significant, such that the association between greater occupational complexity with data and higher semantic memory was stronger among Latinos, compared to other racial groups.ConclusionWithin a diverse cohort, greater occupational complexity with data and people were associated with higher late‐life cognition. Occupational complexity scores varied by race and ethnicity, as well as its associations with cognitive domains. These findings suggest that racial and ethnic differences in occupational complexity may contribute to cognitive health disparities.