Baek Seong-Uk, Yoon Jin-Ha
Graduate School, Yonsei University College of Medicine, Seoul, Korea.
Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
J Gen Intern Med. 2025 May 27. doi: 10.1007/s11606-025-09617-0.
Globally, many countries are experiencing rapid aging of their working populations. Moreover, older workers are particularly susceptible to poor employment conditions, which can contribute to health inequalities.
We explored the association between precarious employment (PE) and cognitive decline.
A longitudinal analysis of a cohort of Korean workers.
We included a nationwide sample of Korean adults aged ≥45 years (n = 2137), with repeated measurements conducted biennially from 2006 to 2020 (6290 observations).
PE was assessed based on three dimensions: employment insecurity, income inadequacy, and a lack of rights and protection. A summative score was used to categorize an individual's PE into quartiles (lowest, low, high, and highest). Cognitive decline was defined as a decrease in the Mini-Mental State Examination score by ≥3 after a 2-year follow-up. Generalized estimating equations were used to determine the association between PE and cognitive decline. We estimated odds ratios (ORs) and 95% confidence intervals (CIs).
The mean age was 51.6 years, and the mean baseline MMSE score was 28.7. During the study period, cognitive decline was observed in 15.1% of the observations over a 2-year follow-up. Regarding each PE element, workers with the lowest wage (<60% of the median) was associated with increased odds of experiencing cognitive decline (OR, 1.45; 95% CI, 1.02-2.06). Based on a summative score, workers with high or the highest PE levels had increased odds of experiencing cognitive decline (OR, 1.38; 95% CI, 1.07-1.77 for high PE and OR, 1.51; 95% CI, 1.14-1.99 for the highest PE) compared with workers with the lowest PE level.
This study suggests that PE is a risk factor for cognitive decline in workers. Enhancing employment conditions for older adults is crucial for promoting healthy aging.
在全球范围内，许多国家正经历劳动人口的快速老龄化。此外，老年劳动者尤其容易受到不良就业条件的影响，这可能导致健康不平等。
我们探讨了不稳定就业（PE）与认知衰退之间的关联。
对一组韩国工人进行纵向分析。
我们纳入了全国范围内年龄≥45岁的韩国成年人样本（n = 2137），从2006年到2020年每两年进行一次重复测量（6290次观察）。
根据三个维度评估PE：就业不安全感、收入不足以及缺乏权利和保护。使用汇总分数将个体的PE分为四分位数（最低、低、高和最高）。认知衰退定义为在2年随访后简易精神状态检查表得分下降≥3分。使用广义估计方程来确定PE与认知衰退之间的关联。我们估计了比值比（OR）和95%置信区间（CI）。
平均年龄为51.6岁，平均基线MMSE得分为28.7。在研究期间，在2年随访中有15.1%的观察对象出现认知衰退。关于每个PE因素，工资最低（低于中位数的60%）的工人出现认知衰退的几率增加（OR，1.45；95%CI，1.02 - 2.06）。基于汇总分数，与PE水平最低的工人相比，PE水平高或最高的工人出现认知衰退的几率增加（高PE的OR，1.38；95%CI，1.07 - 1.77；最高PE的OR，1.51；95%CI，1.14 - 1.99）。
本研究表明，PE是工人认知衰退的一个风险因素。改善老年人的就业条件对于促进健康老龄化至关重要。
