Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany.
Munich Center of Health Sciences (MC-Health), Munich, Germany.
BMC Public Health. 2018 Nov 14;18(1):1256. doi: 10.1186/s12889-018-6171-5.
The effect of shift work on impairment of cognition in later life has not yet been sufficiently investigated. Therefore, we aimed at testing the feasibility of a large-scale epidemiologic study examining this putative association in a pilot study.
Between January and April 2017, a cross-sectional study invited a random sample of 425 former and current employees of a German university hospital aged 55 years and older to undergo a cognitive test battery (including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Letter-Number Span, and Vocabulary Test) and to complete a self-administered questionnaire on socio-demographic characteristics, chronotype, sleep, occupational history including shift work, and medical history. Fifty percent of the invitees were registered in the hospital's occupational records as currently working or having worked in a shift system. The feasibility of a large-scale study was evaluated by the response of the study sample and the completeness of data. In addition, we calculated the prevalence of shift work and cognitive impairment in the study population.
Seventy five subjects (18%) completed the questionnaire, of whom 47 (11% of the total sample) participated in cognitive testing. In all but four items assessed in the questionnaire, the proportion of missing data was below 10 %, suggesting that the quality of collected data can be considered as high. Eighty percent of the participants reported that they ever worked in a shift system, indicating selective participation by exposure to shift work. With respect to chronotype, the majority of the study subjects rated themselves as rather evening type, while a quarter considered themselves as definite morning type. All cognitive tests could be carried out completely. We observed slight difficulties in at least one of the cognitive tests in 17 participants (36%) while two participants (4%) showed more pronounced signs of cognitive impairment.
The present pilot study only partially supported the feasibility of the planned large-scale study. As response rates were low and depended on exposure to shift work, a better way of sampling and recruitment needs to be identified. The questionnaire and the test battery appear to be viable instruments.
轮班工作对晚年认知障碍的影响尚未得到充分研究。因此，我们旨在通过一项试点研究来检验一项大规模流行病学研究检测这种潜在关联的可行性。
在 2017 年 1 月至 4 月期间，一项横断面研究邀请了德国一家大学医院的 425 名年龄在 55 岁及以上的前雇员和现雇员参加认知测试（包括重复性认知评估量表、连线测试、数字-字母测试和词汇测试），并完成一份关于社会人口特征、睡眠时型、睡眠、职业史（包括轮班工作）和病史的自我管理问卷。邀请者的一半被医院的职业记录登记为目前正在轮班工作或曾轮班工作过。通过研究样本的反应和数据的完整性来评估大规模研究的可行性。此外，我们还计算了研究人群中轮班工作和认知障碍的患病率。
75 名受试者（18%）完成了问卷，其中 47 名（总样本的 11%）参加了认知测试。在问卷中评估的所有项目中，除了 4 项之外，缺失数据的比例均低于 10%，这表明所收集数据的质量可以被认为是高的。80%的参与者报告说他们曾在轮班工作，这表明轮班工作的暴露会导致选择性参与。就时型而言，大多数研究对象认为自己属于较晚的时型，而四分之一的人认为自己是明确的早型。所有的认知测试都可以完全进行。我们观察到 17 名参与者（36%）至少有一项认知测试存在轻微困难，而 2 名参与者（4%）表现出更明显的认知障碍迹象。
本试点研究仅部分支持计划中的大规模研究的可行性。由于响应率较低且取决于轮班工作的暴露，需要确定更好的抽样和招募方法。问卷和测试组合似乎是可行的工具。
