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美国老年人种族多样化样本中的退休与认知老化。

Retirement and cognitive aging in a racially diverse sample of older Americans.

机构信息

Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA.

Department of Neurology, Charles University, Second Faculty of Medicine and Motol University Hospital, Prague, Czech Republic.

出版信息

J Am Geriatr Soc. 2023 Sep;71(9):2769-2778. doi: 10.1111/jgs.18475. Epub 2023 Jul 19.

Abstract

BACKGROUND

Retirement represents a crucial transitional period for many adults with possible consequences for cognitive aging. We examined trajectories of cognitive change before and after retirement in Black and White adults.

METHODS

Longitudinal examination of up to 10 years (mean = 7.1 ± 2.2 years) using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study-a national, longitudinal study of Black and White adults ≥45 years of age. Data were from 2226 members of the REGARDS study who retired around the time when an occupational ancillary survey was administered. Cognitive function was an average of z-scores for tests of verbal fluency, memory, and global function.

RESULTS

Cognitive functioning was stable before retirement (Estimate = 0.05, p = 0.322), followed by a significant decline after retirement (Estimate = -0.15, p < 0.001). The decline was particularly pronounced in White (Estimate = -0.19, p < 0.001) compared with Black (Estimate = -0.07, p = 0.077) participants, twice as large in men (Estimate = -0.20, p < 0.001) compared with women (Estimate = -0.11, p < 0.001), highest among White men (Estimate = -0.22, p < 0.001) and lowest in Black women (Estimate = -0.04, p = 0.457). Greater post-retirement cognitive decline was also observed among participants who attended college (Estimate = -0.14, p = 0.016). While greater work complexity (Estimate = 0.92, p < 0.05) and higher income (Estimate = 1.03, p < 0.05) were related to better cognitive function at retirement, neither was significantly related to cognitive change after retirement.

CONCLUSION

Cognitive functioning may decline at an accelerated rate immediately post-retirement, more so in White adults and men than Black adults and women. Lifelong structural inequalities including occupational segregation and other social determinants of cognitive health may obscure the role of retirement in cognitive aging.

摘要

背景

退休是许多成年人的一个重要过渡阶段,可能对认知衰老产生影响。我们研究了黑人和白人成年人退休前后的认知变化轨迹。

方法

使用来自 Reasons for Geographic and Racial Differences in Stroke(REGARDS)研究的数据进行纵向检查,该研究是一项针对≥45 岁的黑人和白人成年人的全国性纵向研究。REGARDS 研究中有 2226 名成员在进行职业辅助调查时退休,这些数据来自 REGARDS 研究。认知功能是言语流畅性、记忆和整体功能测试的 z 分数平均值。

结果

退休前认知功能稳定(估计值=0.05,p=0.322),退休后认知功能显著下降(估计值=-0.15,p<0.001)。与黑人(估计值=-0.07,p=0.077)参与者相比,白种人(估计值=-0.19,p<0.001)参与者的下降更为明显,男性(估计值=-0.20,p<0.001)的下降幅度是女性(估计值=-0.11,p<0.001)的两倍,白种男性(估计值=-0.22,p<0.001)的下降幅度最大,黑种女性(估计值=-0.04,p=0.457)的下降幅度最小。退休后认知衰退较大的参与者中,上过大学的(估计值=-0.14,p=0.016)比例较高。虽然工作复杂性较高(估计值=0.92,p<0.05)和收入较高(估计值=1.03,p<0.05)与退休时的认知功能较好相关,但两者均与退休后认知变化无显著相关性。

结论

认知功能可能会在退休后立即以更快的速度下降,白种人和男性比黑种人和女性更为明显。包括职业隔离和认知健康其他社会决定因素在内的终身结构性不平等可能会掩盖退休对认知衰老的作用。

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