Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
Clinical Memory Research Unit, Lund University, 221 00, Lund, Sweden.
Alzheimers Res Ther. 2019 Dec 27;11(1):112. doi: 10.1186/s13195-019-0570-4.
Growing evidence suggests a role of occupation in the emergence and manifestation of dementia. Occupations are often defined by complexity level, although working environments and activities differ in several other important ways. We aimed to capture the multi-faceted nature of occupation through its measurement as a qualitative (instead of a quantitative) variable and explored its relationship with different types of dementia.
We collected occupational information of 2121 dementia patients with various suspected etiologies from the Amsterdam Dementia Cohort (age 67 ± 8, 57% male; MMSE 21 ± 5). Our final sample included individuals with Alzheimer's disease (AD) dementia (n = 1467), frontotemporal dementia (n = 281), vascular dementia (n = 98), Lewy body disease (n = 174), and progressive supranuclear palsy/corticobasal degeneration (n = 101). Within the AD group, we used neuropsychological data to further characterize patients by clinical phenotypes. All participants were categorized into 1 of 11 occupational classes, across which we evaluated the distribution of dementia (sub)types with χ analyses. We gained further insight into occupation-dementia relationships through post hoc logistic regressions that included various demographic and health characteristics as explanatory variables.
There were significant differences in the distribution of dementia types across occupation groups (χ = 85.87, p < .001). Vascular dementia was relatively common in the Transportation/Logistics sector, and higher vascular risk factors partly explained this relationship. AD occurred less in Transportation/Logistics and more in Health Care/Welfare occupations, which related to a higher/lower percentage of males. We found no relationships between occupational classes and clinical phenotypes of AD (χ = 53.65, n.s.).
Relationships between occupation and dementia seem to exist beyond the complexity level, which offers new opportunities for disease prevention and improvement of occupational health policy.
越来越多的证据表明职业在痴呆的发生和表现中起作用。职业通常通过复杂程度来定义，尽管工作环境和活动在其他几个重要方面存在差异。我们旨在通过将职业测量为定性（而不是定量）变量来捕捉职业的多面性，并探讨其与不同类型痴呆症的关系。
我们从阿姆斯特丹痴呆队列中收集了 2121 名各种疑似病因的痴呆症患者的职业信息（年龄 67±8 岁，57%为男性；MMSE 21±5）。我们的最终样本包括阿尔茨海默病（AD）痴呆症（n=1467）、额颞叶痴呆症（n=281）、血管性痴呆症（n=98）、路易体病（n=174）和进行性核上性麻痹/皮质基底节变性（n=101）患者。在 AD 组中，我们使用神经心理学数据进一步根据临床表型对患者进行分类。所有参与者分为 11 个职业类别之一，我们通过 χ 分析评估痴呆（亚型）在这些类别中的分布。我们通过包含各种人口统计学和健康特征作为解释变量的事后逻辑回归，进一步深入了解职业与痴呆症的关系。
不同职业类别的痴呆症类型分布存在显著差异（χ=85.87，p<.001）。血管性痴呆在运输/物流部门相对常见，较高的血管危险因素部分解释了这种关系。AD 在运输/物流部门较少，在医疗保健/福利部门较多，这与男性比例较高/较低有关。我们没有发现职业类别与 AD 的临床表型之间存在关系（χ=53.65，n.s.）。
职业与痴呆症之间的关系似乎超出了复杂程度，这为疾病预防和改善职业健康政策提供了新的机会。
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