Elovainio M, Ferrie J E, Singh-Manoux A, Gimeno D, De Vogli R, Shipley M J, Vahtera J, Brunner E J, Marmot M G, Kivimäki M
University College London, London, UK.
Occup Environ Med. 2009 Jan;66(1):32-7. doi: 10.1136/oem.2008.039305. Epub 2008 Sep 19.
A high-strain job (a combination of high job demands and low job control) is expected to increase the risk of health problems, whereas an active job (high demands and high control) can be hypothesised to be associated with a greater capacity to learn. We tested associations between high-strain and active jobs and cognitive function in middle-aged men and women.
Data on 4146 British civil servants (2989 men and 1157 women) aged 35-55 years at baseline came from the Whitehall II study. Cumulative exposure to both high-strain and active jobs was assessed at phases 1 (1985-1988), 2 (1989-1990) and 3 (1991-1993). Cognitive performance was assessed at phases 5 (1997-1999) and 7 (2003-2004) using the following tests: verbal memory, inductive reasoning (Alice Heim), verbal meaning (Mill Hill), phonemic and semantic fluency. Analyses were adjusted for age, sex and employment grade.
Longer exposure to high job strain and shorter exposure to active jobs were associated with lower scores in most of the cognitive performance tests. However, these associations disappeared on adjustment for employment grade. Phonemic fluency was an exception to this pattern. Associations between exposure to an active job and phonemic fluency at both follow-up phases were robust to adjustment for employment grade. However, there was no association between exposure to active jobs and change in phonemic fluency score between the follow-up phases after adjustment for employment grade.
In these data, associations between cumulative exposure to high-strain or active jobs and cognition are largely explained by socioeconomic position.
高应变工作（高工作要求与低工作控制相结合）预计会增加健康问题风险，而积极工作（高要求与高控制）可被推测与更强的学习能力相关。我们测试了高应变和积极工作与中年男性和女性认知功能之间的关联。
来自白厅II研究的4146名英国公务员（2989名男性和1157名女性）的数据，这些人在基线时年龄为35 - 55岁。在第1阶段（1985 - 1988年）、第2阶段（1989 - 1990年）和第3阶段（1991 - 1993年）评估了对高应变和积极工作的累积暴露情况。在第5阶段（1997 - 1999年）和第7阶段（2003 - 2004年）使用以下测试评估认知表现：言语记忆、归纳推理（爱丽丝·海姆测试）、言语意义（米尔希尔测试）、音素流畅性和语义流畅性。分析对年龄、性别和就业等级进行了调整。
长时间暴露于高工作应变和短时间暴露于积极工作与大多数认知表现测试中的较低分数相关。然而，在对就业等级进行调整后，这些关联消失了。音素流畅性是这种模式的一个例外。在两个随访阶段，暴露于积极工作与音素流畅性之间的关联在对就业等级进行调整后仍然稳健。然而，在对就业等级进行调整后，随访阶段之间暴露于积极工作与音素流畅性分数变化之间没有关联。
在这些数据中，高应变或积极工作的累积暴露与认知之间的关联在很大程度上由社会经济地位所解释。
