Don Carlo Gnocchi Foundation, IRCSS, Florence, Italy.
SOC Neurologia, Ospedale San Giovanni di Dio, AUSL Toscana Centro, Florence, Italy.
Aging Ment Health. 2021 Sep;25(9):1630-1635. doi: 10.1080/13607863.2020.1746739. Epub 2020 Apr 7.
The theory of "Cognitive Reserve" assumes that premorbid factors such as high educational and occupational attainment may enable a better way of coping with brain damage. It has been suggested that more stimulating lifestyles, including more complex work environments, may provide a buffer against cognitive decline in later life. This study aimed to investigate the association between occupational history and cognitive decline in a large cohort of Italian oldest-old.
392 individuals (266 women/126 men, mean age 93 ± 3 years) enrolled in the "Mugello study" provided information about their work history. Jobs were classified in nine categories, according to the level of expertise required to perform them, as suggested by the Italian National Institute for Statistics (ISTAT). In addition, socio-demographic characteristics, comorbidities, level of independence, depression, and cognitive status were assessed. The presence of dementia was established based on cognitive status and independence in performing four selected instrumental activities of daily living (ability to manage telephone, transportation, medications, and budget).
Neither work complexity ( = 0.995) nor work duration ( = 0.701) showed a significant effect on the likelihood of presenting a lower cognitive profile or developing dementia ( = 0.385 and = 0.096, for work complexity and work duration, respectively).
In the observed sample of oldest-old individuals, cognitive decline did not seem to be influenced by cognitive reserve as assessed through the evaluation of cognitive status and level of independence. It is conceivable that in this population, the decline of the brain reserve has a preponderant role in the definition of the cognitive profile.
“认知储备”理论假设，发病前的因素，如高教育和职业水平的获得，可能使人们能够以更好的方式应对大脑损伤。有人认为，更具刺激性的生活方式，包括更复杂的工作环境，可能为晚年认知能力下降提供缓冲。本研究旨在调查意大利高龄人群的职业史与认知能力下降之间的关系。
392 名参与者（266 名女性/126 名男性，平均年龄 93±3 岁）参加了“Mugello 研究”，提供了他们的工作经历信息。根据意大利国家统计局（ISTAT）的建议，根据完成工作所需的专业水平，将工作分为九个类别。此外，评估了社会人口统计学特征、合并症、独立性水平、抑郁和认知状况。痴呆的存在是根据认知状态和执行四项选定的日常生活活动工具（管理电话、交通、药物和预算的能力）的独立性来确定的。
工作复杂性（ = 0.995）和工作持续时间（ = 0.701）均未对出现认知水平较低或发生痴呆的可能性产生显著影响（ = 0.385 和 = 0.096，分别用于工作复杂性和工作持续时间）。
在观察到的高龄个体样本中，认知能力下降似乎不受通过评估认知状态和独立性来评估的认知储备的影响。可以想象，在该人群中，大脑储备的下降在认知特征的定义中起着主导作用。
