Section of Occupational Medicine, Department of Public Health, University of Naples Federico II, Naples, Italy.
Eur Rev Med Pharmacol Sci. 2021 Jan;25(1):222-232. doi: 10.26355/eurrev_202101_24388.
Dementia is a neurodegenerative disorder characterized by a progressive decline in multiple cognitive domains. Individual and/or environmental risk factors, i.e., aging, are involved in its pathogenesis. It is possible that shift and night works, affecting circadian rhythms, may contribute to the occurrence/progression of the disease. Therefore, aim of this review was to provide an overview on the possible association between shift or night work and cognitive decline.
A systematic review of literature studies available in PubMed, Scopus, and ISI Web of Science databases, addressing the possible relationship between shift or night work and dementia was performed.
Not-homogeneous findings emerged from the revised studies. Some results supported a positive association between shift work and increased risk of dementia, although with a not unique evidence concerning the role of night work schedules and the consequent circadian misalignment in disease pathogenesis. Cardiometabolic disorders, underlying lifestyles, and additional occupational risk factors, including, psychosocial stress, may act as mediators in the shift work-dementia relationship, that may be overall affected by the individual genetic susceptibility too. Length of employment in shift works was also suggested to be responsible for cognitive damaging effects.
The limited number of available studies, the several and different work schedules analyzed, together with the possible co-exposure to other occupational risk factors prevent to draw conclusions on shift work-dementia relationship. Further research should confirm such association and the causal relation with early cognitive alterations in order to guide suitable occupational risk assessment, as well as to promote healthy lifestyle and occupational management strategies, with the ultimate goal of preventing cognitive decline of shift workers. This may overall support the active aging of the workforce while providing benefits for the public health system.
痴呆是一种神经退行性疾病，其特征是多个认知领域的进行性下降。个体和/或环境风险因素，如衰老，参与其发病机制。轮班和夜班工作可能会影响昼夜节律，从而导致疾病的发生/进展。因此，本综述的目的是提供轮班或夜班工作与认知能力下降之间可能存在关联的概述。
对 PubMed、Scopus 和 ISI Web of Science 数据库中可用的文献研究进行了系统综述，以探讨轮班或夜班工作与痴呆之间的可能关系。
从修订后的研究中得出的结果不一致。一些结果支持轮班工作与痴呆风险增加之间存在正相关关系，但关于夜班工作时间表的作用以及由此导致的昼夜节律失调在疾病发病机制中的作用的证据并不独特。代谢紊乱、潜在的生活方式以及其他职业风险因素，包括心理社会压力，可能作为轮班工作与痴呆关系的中介因素，而个体遗传易感性也可能影响这种关系。轮班工作中的就业时间也被认为是导致认知损害的原因。
可用研究数量有限，分析的工作时间表也各不相同，再加上可能同时暴露于其他职业风险因素，使得无法对轮班工作与痴呆之间的关系得出结论。进一步的研究应该证实这种关联以及与早期认知改变的因果关系，以便指导进行适当的职业风险评估，促进健康的生活方式和职业管理策略，最终目标是预防轮班工人的认知能力下降。这可能会整体支持劳动力的积极老龄化，并为公共卫生系统带来益处。
