Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Japan.
PLoS One. 2020 Jun 8;15(6):e0234392. doi: 10.1371/journal.pone.0234392. eCollection 2020.
Although many governments are promoting workforce participation (WP) by older people, evidence of WP's effects on active aging is inadequate. We examined whether there is a gender-specific beneficial effect of lifetime WP from adulthood though old age against self-reported cognitive decline (CD) among community-dwelling older adults.
We used data from a community-based prospective study of 2,422 men and 2,852 women aged ≥65 with neither poor cognition nor disability in basic activities of daily living at baseline. Self-reported CD was measured using the Cognitive Performance Scale. Lifetime WP evaluated the presence or absence of WP at baseline, the longest-held occupation, and lifetime working years (total working years throughout lifetime). Generalized estimating equations of the multivariable Poisson regression model were applied to evaluate a cumulative incidence ratio (CIR) for self-reported CD and a 95% confidence interval (CI), controlled for age, education, self-perceived economic status, chronic medical conditions, smoking history, physical activity, depression, and instrumental activities of daily living. To examine any gender-specific association, stratified analyses by gender were performed.
The 33-month cumulative incidence of self-reported CD was 15.7% in men and 14.4% in women. After covariate adjustments and mutual adjustment for three items of lifetime WP, men who had their longest held job in a white-collar occupation reported significantly decreased self-reported CD compared to men engaged in blue-collar jobs (CIR 0.72; 95% CI, 0.57-0.91), and women had a significant dose-response relationship between longer lifetime working years and less decline in subjective cognitive functioning (P for trend <0.029). Among both genders, WP at baseline was not associated with self-reported CD.
Our results suggest that lifetime WP, especially lifetime principal occupation in men and lifetime working years in women, may play a more prominent role in preventing self-reported CD than later-life WP.
尽管许多政府都在推动老年人参与劳动力市场，但有关劳动力参与对积极老龄化影响的证据还不够充分。我们研究了从成年到老年的终身劳动力参与是否对社区居住的老年人的自我报告认知能力下降（CD）有性别特异性的有益影响。
我们使用了一项基于社区的前瞻性研究的数据，该研究纳入了 2422 名男性和 2852 名女性，年龄均≥65 岁，在基线时既没有认知能力差，也没有基本日常生活活动的残疾。自我报告的 CD 使用认知表现量表进行测量。终身劳动力参与评估了基线时、最长从事的职业和终身工作年限（一生中的总工作年限）是否存在劳动力参与。应用多变量泊松回归模型的广义估计方程来评估自我报告 CD 的累积发病率比（CIR）和 95%置信区间（CI），控制年龄、教育程度、自我感知的经济状况、慢性疾病、吸烟史、身体活动、抑郁和日常生活活动的工具。为了检查任何性别特异性关联，我们对性别进行了分层分析。
男性的 33 个月累积自我报告 CD 发生率为 15.7%，女性为 14.4%。在调整协变量以及对终身 WP 的三个项目进行相互调整后，与从事蓝领工作的男性相比，从事白领职业的男性报告的自我报告 CD 显著降低（CIR 0.72；95%CI，0.57-0.91），而女性的主观认知功能下降与更长的终身工作年限之间存在显著的剂量-反应关系（P 趋势<0.029）。在两种性别中，基线时的 WP 与自我报告的 CD 无关。
我们的研究结果表明，终身 WP，特别是男性的终身主要职业和女性的终身工作年限，可能在预防自我报告的 CD 方面发挥比晚年 WP 更突出的作用。
