Abstract
In this population-based prospective study, we examined the association of job demand-control combinations with dementia, and explored the roles of Apolipoprotein E epsilon4 (APOE ɛ4) and work duration in this association. A total of 2,579 dementia-free individuals aged 60+ years from Sweden were followed over 12 years. Dementia diagnosis was made by physicians. Lifelong occupational experience was collected, and job demands and control were assessed using a psychosocial job-exposure matrix. Data were analyzed using multivariate Cox proportional hazard models. During the follow-up, 282 people developed dementia. Passive jobs (low control/low demands) were related to a higher risk of dementia compared with active jobs (high control/high demands) among the younger-old (aged ≤72 years), but not among the older-old (aged ≥78 years). Among the younger-old, compared to those with no passive job experience, those with 11+ years in passive jobs had a higher dementia risk. The joint-effect analyses showed that APOE ɛ4 carriers with passive jobs had an even higher risk of dementia compared to APOE ɛ4 non-carriers with active jobs. These findings suggest that passive jobs are related to a higher dementia risk among the younger-old. APOE ɛ4 and long work duration may amplify the impact of passive jobs on dementia.
Highlights
Dementia is a multifactorial disorder characterized by progressive deterioration in multiple cognitive domains severe enough to interfere with daily functioning [1]
All sensitivity analyses produced similar results to those from initial analyses. In this population-based cohort study, the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K), we found that passive jobs were associated with a higher risk of dementia among the younger-old, but not among the older-old
Among the younger-old, there was an interaction between APOE ɛ4 and passive jobs in terms of dementia occurrence
Summary
Dementia is a multifactorial disorder characterized by progressive deterioration in multiple cognitive domains severe enough to interfere with daily functioning [1]. One of the most prominent models to evaluate psychosocial work environment is the job demand-control model [3]. Passive jobs (low demands/low control), on the other hand, entail lack of motivation and mental stimulation, and may be detrimental for learning capacity and cognitive performance [3]. Both high strain and passive jobs have been associated with worse cognitive function in late life [5,6,7]. In a previous study we reported the relationship of high strain and passive jobs to a higher risk of dementia using data from the Kungsholmen Project (KP) [10]
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