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. 2004 Dec;61(12):962–971. doi: 10.1136/oem.2003.012153

Psychosocial work factors and dementia

A Seidler 1, A Nienhaus 1, T Bernhardt 1, T Kauppinen 1, A Elo 1, L Frolich 1
PMCID: PMC1740682  PMID: 15550601

Abstract

Aims: To evaluate the association between psychosocial workplace factors and dementia in a case-control study.

Methods: Patients with dementia (aged 55–99 years) were recruited from 23 general practices in the city of Frankfurt-on-Main and surrounding area in 1998–2000. Of these, 108 were suffering from possible Alzheimer's disease, 59 from possible vascular dementia, and 28 from secondary or unclassified dementia. A total of 229 control subjects (aged 60–94 years) was recruited from the same study region: 122 population controls and 107 dementia-free ambulatory patients. A detailed job history was elicited in a structured personal interview (next-of-kin interviews of cases). Psychosocial work exposure was assigned to cases and control subjects by linking lifetime job histories with a Finnish job-exposure matrix. Data were analysed using logistic regression, to control for age, region, sex, dementia in parents, education, smoking, and the psychosocial network at age 30.

Results: There were decreased odds ratios for high challenge at work, high control possibilities at work, and high social demands at work. High risks for error at work revealed a significant positive association with the diagnosis of dementia. Restriction of the analysis to cases with possible Alzheimer's disease or to cases with possible vascular dementia led to similar results.

Conclusions: These results support a role for psychosocial work factors in the aetiology of dementia. As an alternative explanation, people might have chosen jobs with poor work factors due to preclinical dementia, which becomes clinically manifest decades later.

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Selected References

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  1. Bergmann E., Kamtsiuris P. Inanspruchnahme medizinischer Leistungen. Gesundheitswesen. 1999 Dec;61(Spec No):S138–S144. [PubMed] [Google Scholar]
  2. Bickel H., Cooper B. Incidence and relative risk of dementia in an urban elderly population: findings of a prospective field study. Psychol Med. 1994 Feb;24(1):179–192. doi: 10.1017/s0033291700026945. [DOI] [PubMed] [Google Scholar]
  3. Fabrigoule C., Letenneur L., Dartigues J. F., Zarrouk M., Commenges D., Barberger-Gateau P. Social and leisure activities and risk of dementia: a prospective longitudinal study. J Am Geriatr Soc. 1995 May;43(5):485–490. doi: 10.1111/j.1532-5415.1995.tb06093.x. [DOI] [PubMed] [Google Scholar]
  4. Fratiglioni L. Epidemiology of Alzheimer's disease. Issues of etiology and validity. Acta Neurol Scand Suppl. 1993;145:1–70. [PubMed] [Google Scholar]
  5. Fratiglioni L., Wang H. X., Ericsson K., Maytan M., Winblad B. Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet. 2000 Apr 15;355(9212):1315–1319. doi: 10.1016/S0140-6736(00)02113-9. [DOI] [PubMed] [Google Scholar]
  6. Friedland R. P., Fritsch T., Smyth K. A., Koss E., Lerner A. J., Chen C. H., Petot G. J., Debanne S. M. Patients with Alzheimer's disease have reduced activities in midlife compared with healthy control-group members. Proc Natl Acad Sci U S A. 2001 Mar 6;98(6):3440–3445. doi: 10.1073/pnas.061002998. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Helmer C., Damon D., Letenneur L., Fabrigoule C., Barberger-Gateau P., Lafont S., Fuhrer R., Antonucci T., Commenges D., Orgogozo J. M. Marital status and risk of Alzheimer's disease: a French population-based cohort study. Neurology. 1999 Dec 10;53(9):1953–1958. doi: 10.1212/wnl.53.9.1953. [DOI] [PubMed] [Google Scholar]
  8. Kauppinen T., Toikkanen J., Pukkala E. From cross-tabulations to multipurpose exposure information systems: a new job-exposure matrix. Am J Ind Med. 1998 Apr;33(4):409–417. doi: 10.1002/(sici)1097-0274(199804)33:4<409::aid-ajim12>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  9. Kondo K., Niino M., Shido K. A case-control study of Alzheimer's disease in Japan--significance of life-styles. Dementia. 1994 Nov-Dec;5(6):314–326. doi: 10.1159/000106741. [DOI] [PubMed] [Google Scholar]
  10. Kropiunigg U., Sebek K., Leonhardsberger A., Schemper M., Dal-Bianco P. Psychosoziale Risikofaktoren für die Alzheimer Krankheit. Psychother Psychosom Med Psychol. 1999 May;49(5):153–159. [PubMed] [Google Scholar]
  11. Kukull W. A., Larson E. B., Bowen J. D., McCormick W. C., Teri L., Pfanschmidt M. L., Thompson J. D., O'Meara E. S., Brenner D. E., van Belle G. Solvent exposure as a risk factor for Alzheimer's disease: a case-control study. Am J Epidemiol. 1995 Jun 1;141(11):1059–1079. doi: 10.1093/oxfordjournals.aje.a117370. [DOI] [PubMed] [Google Scholar]
  12. Laurin D., Verreault R., Lindsay J., MacPherson K., Rockwood K. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol. 2001 Mar;58(3):498–504. doi: 10.1001/archneur.58.3.498. [DOI] [PubMed] [Google Scholar]
  13. Martyn C. N., Coggon D. N., Inskip H., Lacey R. F., Young W. F. Aluminum concentrations in drinking water and risk of Alzheimer's disease. Epidemiology. 1997 May;8(3):281–286. doi: 10.1097/00001648-199705000-00009. [DOI] [PubMed] [Google Scholar]
  14. McKhann G., Drachman D., Folstein M., Katzman R., Price D., Stadlan E. M. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984 Jul;34(7):939–944. doi: 10.1212/wnl.34.7.939. [DOI] [PubMed] [Google Scholar]
  15. Peter R., Siegrist J. Psychosocial work environment and the risk of coronary heart disease. Int Arch Occup Environ Health. 2000 Jun;73 (Suppl):S41–S45. doi: 10.1007/pl00014625. [DOI] [PubMed] [Google Scholar]
  16. Qiu Chengxuan, Karp Anita, von Strauss Eva, Winblad Bengt, Fratiglioni Laura, Bellander Tom. Lifetime principal occupation and risk of Alzheimer's disease in the Kungsholmen project. Am J Ind Med. 2003 Feb;43(2):204–211. doi: 10.1002/ajim.10159. [DOI] [PubMed] [Google Scholar]
  17. Scarmeas N., Levy G., Tang M. X., Manly J., Stern Y. Influence of leisure activity on the incidence of Alzheimer's disease. Neurology. 2001 Dec 26;57(12):2236–2242. doi: 10.1212/wnl.57.12.2236. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Scarmeas Nikolaos, Stern Yaakov. Cognitive reserve and lifestyle. J Clin Exp Neuropsychol. 2003 Aug;25(5):625–633. doi: 10.1076/jcen.25.5.625.14576. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Seidler Andreas, Bernhardt Tanja, Nienhaus Albert, Frölich Lutz. Association between the psychosocial network and dementia--a case-control study. J Psychiatr Res. 2003 Mar-Apr;37(2):89–98. doi: 10.1016/s0022-3956(02)00065-1. [DOI] [PubMed] [Google Scholar]
  20. Stern Y., Gurland B., Tatemichi T. K., Tang M. X., Wilder D., Mayeux R. Influence of education and occupation on the incidence of Alzheimer's disease. JAMA. 1994 Apr 6;271(13):1004–1010. [PubMed] [Google Scholar]
  21. Theorell T., Karasek R. A. Current issues relating to psychosocial job strain and cardiovascular disease research. J Occup Health Psychol. 1996 Jan;1(1):9–26. doi: 10.1037//1076-8998.1.1.9. [DOI] [PubMed] [Google Scholar]
  22. Verghese Joe, Lipton Richard B., Katz Mindy J., Hall Charles B., Derby Carol A., Kuslansky Gail, Ambrose Anne F., Sliwinski Martin, Buschke Herman. Leisure activities and the risk of dementia in the elderly. N Engl J Med. 2003 Jun 19;348(25):2508–2516. doi: 10.1056/NEJMoa022252. [DOI] [PubMed] [Google Scholar]
  23. Wang Hui-Xin, Karp Anita, Winblad Bengt, Fratiglioni Laura. Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: a longitudinal study from the Kungsholmen project. Am J Epidemiol. 2002 Jun 15;155(12):1081–1087. doi: 10.1093/aje/155.12.1081. [DOI] [PubMed] [Google Scholar]
  24. Wetterling T., Kanitz R. D., Borgis K. J. Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke. 1996 Jan;27(1):30–36. doi: 10.1161/01.str.27.1.30. [DOI] [PubMed] [Google Scholar]
  25. Wilson Robert S., Mendes De Leon Carlos F., Barnes Lisa L., Schneider Julie A., Bienias Julia L., Evans Denis A., Bennett David A. Participation in cognitively stimulating activities and risk of incident Alzheimer disease. JAMA. 2002 Feb 13;287(6):742–748. doi: 10.1001/jama.287.6.742. [DOI] [PubMed] [Google Scholar]

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