Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden.
Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna 171 64, Sweden.
Aging (Albany NY). 2020 Feb 20;12(4):3730-3746. doi: 10.18632/aging.102843.
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 ( 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 ɛ4 carriers with passive jobs had an even higher risk of dementia compared to ɛ4 non-carriers with active jobs. These findings suggest that passive jobs are related to a higher dementia risk among the younger-old. ɛ4 and long work duration may amplify the impact of passive jobs on dementia.
在这项基于人群的前瞻性研究中，我们研究了工作需求-控制组合与痴呆的关联，并探讨了载脂蛋白 E ɛ4（ ɛ4）和工作时间在这种关联中的作用。共有 2579 名年龄在 60 岁以上的无痴呆瑞典人随访了 12 年。痴呆症的诊断由医生做出。收集了终生的职业经历，并使用心理社会工作暴露矩阵评估了工作需求和控制。使用多变量 Cox 比例风险模型进行数据分析。在随访期间，282 人患上了痴呆症。与积极工作（高控制/高需求）相比，年轻老年人（≤72 岁）中被动工作（低控制/低需求）与痴呆症的风险更高，但在老年老年人（≥78 岁）中并非如此。在年轻老年人中，与没有被动工作经历的人相比，有 11 年以上被动工作经历的人患痴呆症的风险更高。联合效应分析表明，与载脂蛋白 E ɛ4 非携带者的积极工作相比，载脂蛋白 E ɛ4 携带者的被动工作与更高的痴呆风险相关。这些发现表明，被动工作与年轻老年人中更高的痴呆风险有关。载脂蛋白 E ɛ4 和工作时间长可能会放大被动工作对痴呆的影响。
