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中老年痴呆和认知能力下降:农业工人风险更大吗?

Dementia and Cognitive Decline in Older Adulthood: Are Agricultural Workers at Greater Risk?

机构信息

Department of Health Management and Policy, University of Iowa, USA.

出版信息

J Gerontol B Psychol Sci Soc Sci. 2021 Sep 13;76(8):1629-1643. doi: 10.1093/geronb/gbab005.

Abstract

OBJECTIVES

To examine whether long-term exposure to agricultural work is associated with dementia prevalence and the rate of cognitive change in older adulthood.

METHOD

We employed data from the Health and Retirement Study (1998-2014). Multiple logistic regression was used to determine whether a longest-held job in the agricultural sector was associated with differences in dementia prevalence. We examined if hearing impairment, depression, and physical health indicators mediated the relationship between agricultural work and cognitive functioning. Subgroup analyses were done by age, retirement status, job tenure, and cognitive domain. We employed growth curve models to investigate implications of agricultural work on age trajectories of cognitive functioning.

RESULTS

Longest-held job in agriculture, fishing, and forestry (AFF) was associated with 46% greater odds of having dementia. The relationship between AFF exposure and cognitive functioning was not mediated by hearing impairment, depression, or physical health indicators. Results were stronger among younger and retired older adults as well as those with extensive job tenure. AFF exposure was associated with lower scores in working memory and attention and processing speed. Growth curve models indicated that while agricultural work exposure was associated with lower initial levels of cognitive functioning, over time, the pattern reversed with individuals in non-AFF jobs, showing more accelerated cognitive decline.

DISCUSSION

Consistent with European studies, results from the United States also demonstrate a higher prevalence of dementia among agricultural workers. The cognitive reserve framework may explain the seemingly paradoxical result on age patterning of cognitive performance across older adults with different work histories.

摘要

目的

研究长期从事农业工作是否与老年人痴呆症患病率和认知变化率有关。

方法

我们使用了来自健康与退休研究(1998-2014 年)的数据。采用多变量逻辑回归来确定农业部门的最长工作经历是否与痴呆症患病率的差异有关。我们研究了听力障碍、抑郁和身体健康指标是否在农业工作与认知功能之间的关系中起中介作用。按年龄、退休状态、工作年限和认知域进行了亚组分析。我们采用增长曲线模型来研究农业工作对认知功能年龄轨迹的影响。

结果

从事农业、渔业和林业(AFF)的最长工作经历与痴呆症的患病几率增加 46%有关。AFF 暴露与认知功能之间的关系不受听力障碍、抑郁或身体健康指标的影响。在年轻和退休的老年人以及工作年限较长的老年人中,结果更为明显。AFF 暴露与工作记忆和注意力以及处理速度的得分较低有关。增长曲线模型表明,虽然农业工作暴露与认知功能的初始水平较低有关,但随着时间的推移,这种模式在非 AFF 工作的个体中发生了逆转,表明认知衰退的速度更快。

讨论

与欧洲的研究一致,美国的研究结果也表明农业工人中痴呆症的患病率更高。认知储备框架可以解释不同工作经历的老年人在认知表现的年龄模式上看似矛盾的结果。

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