Högskolan i Skövde

his.sePublications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • apa-cv
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies
Department of Epidemiology and Public Health, University College London, London, UK ; Clinicum, Faculty of Medicine, University of Helsinki, Finland ; Finnish Institute of Occupational Health, Helsinki, Finland.
Department of Neurology, The Johns Hopkins University, Baltimore, MD, USA ; Laboratory of Behavioral Neuroscience, National Institute on Aging, Intramural Research Program, Baltimore, MD, USA.
Clinicum, Faculty of Medicine, University of Helsinki, Finland ; Finnish Institute of Occupational Health, Helsinki, Finland ; Department of Public Health, University of Turku, Finland.
Clinicum, Faculty of Medicine, University of Helsinki, Finland.
Show others and affiliations
2021 (English)In: The BMJ, E-ISSN 1756-1833, Vol. 374, article id n1804Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To examine the association between cognitively stimulating work and subsequent risk of dementia and to identify protein pathways for this association.

DESIGN: Multicohort study with three sets of analyses.

SETTING: United Kingdom, Europe, and the United States.

PARTICIPANTS: Three associations were examined: cognitive stimulation and dementia risk in 107 896 participants from seven population based prospective cohort studies from the IPD-Work consortium (individual participant data meta-analysis in working populations); cognitive stimulation and proteins in a random sample of 2261 participants from one cohort study; and proteins and dementia risk in 13 656 participants from two cohort studies.

MAIN OUTCOME MEASURES: Cognitive stimulation was measured at baseline using standard questionnaire instruments on active versus passive jobs and at baseline and over time using a job exposure matrix indicator. 4953 proteins in plasma samples were scanned. Follow-up of incident dementia varied between 13.7 to 30.1 years depending on the cohort. People with dementia were identified through linked electronic health records and repeated clinical examinations.

RESULTS: During 1.8 million person years at risk, 1143 people with dementia were recorded. The risk of dementia was found to be lower for participants with high compared with low cognitive stimulation at work (crude incidence of dementia per 10 000 person years 4.8 in the high stimulation group and 7.3 in the low stimulation group, age and sex adjusted hazard ratio 0.77, 95% confidence interval 0.65 to 0.92, heterogeneity in cohort specific estimates I2=0%, P=0.99). This association was robust to additional adjustment for education, risk factors for dementia in adulthood (smoking, heavy alcohol consumption, physical inactivity, job strain, obesity, hypertension, and prevalent diabetes at baseline), and cardiometabolic diseases (diabetes, coronary heart disease, stroke) before dementia diagnosis (fully adjusted hazard ratio 0.82, 95% confidence interval 0.68 to 0.98). The risk of dementia was also observed during the first 10 years of follow-up (hazard ratio 0.60, 95% confidence interval 0.37 to 0.95) and from year 10 onwards (0.79, 0.66 to 0.95) and replicated using a repeated job exposure matrix indicator of cognitive stimulation (hazard ratio per 1 standard deviation increase 0.77, 95% confidence interval 0.69 to 0.86). In analysis controlling for multiple testing, higher cognitive stimulation at work was associated with lower levels of proteins that inhibit central nervous system axonogenesis and synaptogenesis: slit homologue 2 (SLIT2, fully adjusted β -0.34, P<0.001), carbohydrate sulfotransferase 12 (CHSTC, fully adjusted β -0.33, P<0.001), and peptidyl-glycine α-amidating monooxygenase (AMD, fully adjusted β -0.32, P<0.001). These proteins were associated with increased dementia risk, with the fully adjusted hazard ratio per 1 SD being 1.16 (95% confidence interval 1.05 to 1.28) for SLIT2, 1.13 (1.00 to 1.27) for CHSTC, and 1.04 (0.97 to 1.13) for AMD.

CONCLUSIONS: The risk of dementia in old age was found to be lower in people with cognitively stimulating jobs than in those with non-stimulating jobs. The findings that cognitive stimulation is associated with lower levels of plasma proteins that potentially inhibit axonogenesis and synaptogenesis and increase the risk of dementia might provide clues to underlying biological mechanisms.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2021. Vol. 374, article id n1804
Keywords [en]
alzheimer's disease, complexity, strain, model
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Research on Citizen Centered Health, University of Skövde (Reacch US)
Identifiers
URN: urn:nbn:se:his:diva-20520DOI: 10.1136/bmj.n1804ISI: 000687459800008PubMedID: 34407988Scopus ID: 2-s2.0-85113526780OAI: oai:DiVA.org:his-20520DiVA, id: diva2:1590304
Funder
Wellcome trust, 221854/Z/20/ZEuropean Commission, 221854/Z/20/Z
Note

CC BY 4.0

Available from: 2021-09-02 Created: 2021-09-02 Last updated: 2023-08-28Bibliographically approved

Open Access in DiVA

fulltext(686 kB)149 downloads
File information
File name FULLTEXT01.pdfFile size 686 kBChecksum SHA-512
0a8431324c91230b9f589f7ec6534a644a2e14f550d73986bb6796ce29eb553eeb5687ef2b42e5ca0daad4acc65c475b2541c36122eec34e87d3a890ba772c23
Type fulltextMimetype application/pdf

Other links

Publisher's full textPubMedScopus

Authority records

Suominen, Sakari

Search in DiVA

By author/editor
Suominen, Sakari
By organisation
School of Health SciencesDigital Health Research (DHEAR)
In the same journal
The BMJ
Public Health, Global Health, Social Medicine and Epidemiology

Search outside of DiVA

GoogleGoogle Scholar
Total: 149 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
pubmed
urn-nbn

Altmetric score

doi
pubmed
urn-nbn
Total: 182 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • apa-cv
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf