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心理挑战性职业对非裔美国人和非西班牙裔白种人罹患痴呆症的影响存在差异。

Effect of Mentally Challenging Occupations on Incident Dementia Differs Between African Americans and Non-Hispanic Whites.

机构信息

Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.

Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

J Alzheimers Dis. 2020;75(4):1405-1416. doi: 10.3233/JAD-191222.

Abstract

BACKGROUND

Engaging in mentally challenging activities may protect against dementia in late life. However, little is known whether the association between mentally challenging activities and dementia risk varies with race/ethnicity.

OBJECTIVE

The current study investigates whether having jobs with higher mental stimulation is differentially associated with a decreased risk of dementia between African Americans (AAs) and non-Hispanic Whites (nHWs).

METHODS

The sample consisted of 1,079 individuals (66% nHWs, 28% AAs; age = 78.6±5.3) from the longitudinal Einstein Aging Study. Occupation information of each participant was collected retrospectively at baseline and was linked to the substantive complexity of work score from the Dictionary of Occupational Titles. Cox proportional hazards models were used to evaluate the associations of occupational complexity with risk of dementia.

RESULTS

Individuals whose jobs had moderate-to-high levels of complexity, compared to those with the lowest complexity, were at modestly decreased risk for incident dementia. When stratified by race, moderate-to-high levels of occupational complexity were significantly associated with lower risk of developing dementia for AAs (HR = 0.35). When risk of dementia was evaluated based on the combinations of race×occupational complexity, AAs with lowest occupational complexity showed the highest risk of developing dementia, while other combinations exhibited lower risk of developing dementia (HRs = 0.36~0.43).

CONCLUSION

Our results suggest that moderate-to-high levels of complexity at work are associated with a decreased risk of incident dementia in AAs. Understanding the differential effects of mentally challenging occupations across race/ethnicity may suggest important intervention strategies that could mitigate racial disparities in dementia rates.

摘要

背景

参与具有挑战性的精神活动可能有助于预防晚年痴呆。然而,人们对精神挑战性活动与痴呆风险之间的关联是否因种族/民族而异知之甚少。

目的

本研究旨在调查从事高精神刺激工作的人是否与非裔美国人(AAs)和非西班牙裔白人(nHWs)的痴呆风险降低有关。

方法

该样本包括来自纵向爱因斯坦老龄化研究的 1079 名参与者(66%为 nHWs,28%为 AAs;年龄=78.6±5.3)。在基线时,通过回顾性收集每位参与者的职业信息,并与职业名称词典中的工作实质性复杂性得分相关联。Cox 比例风险模型用于评估职业复杂性与痴呆风险的关系。

结果

与最低复杂性相比,具有中等到高度复杂性的工作的个体发生痴呆的风险适度降低。按种族分层时,中等到高度的职业复杂性与 AAs 发生痴呆的风险降低显著相关(HR=0.35)。当根据种族×职业复杂性的组合评估痴呆风险时,职业复杂性最低的 AAs 发生痴呆的风险最高,而其他组合的痴呆风险较低(HRs=0.36~0.43)。

结论

我们的结果表明,工作中具有中等到高度的复杂性与 AAs 中发生痴呆的风险降低有关。了解具有挑战性的职业在不同种族/民族之间的差异影响可能为减轻痴呆率的种族差异提供重要的干预策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/607c/7874241/b90f9e9563e9/nihms-1665999-f0001.jpg

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