Enriched Environment at Work and the Incidence of Dementia: Results of the Leipzig Longitudinal Study of the Aged (LEILA 75+)

<div><p>Background</p><p>The high incidence of cognitive impairments in the aging population together with the challenges it imposes on health systems raise the question of what effect working life has on cognitive abilities. Animal models have demonstrated that so called enriched environments protect against neurodegenerative diseases, such as dementia. The aim was to investigate the impact of enriched environment at work on the incidence of dementia.</p><p>Methods</p><p>The Leipzig Longitudinal Study of the Aged (LEILA 75+) is an ongoing representative population cohort study that examines cognitive functioning and dementia in individuals aged 75 years and older. The participants’ occupational information was matched to O*NET SOC codes and the relevant job descriptors were used to create occupational context indices describing enriched environment at work.</p><p>Results</p><p>Results of logistic regression modeling suggest that a higher level of the index <i>Executive</i> was associated with a lower risk of incident dementia (odds ratio  = 0.61, 95% confidence interval  = 0.47–0.79, p<0.001). Adjustment for various confounders did not alter the association. The cognitive stimulation indices were only significant in univariate analysis. The <i>Novelty</i>-index remained non-significant.</p><p>Conclusions</p><p>The results suggest that occupational contexts enriched with independent planning/performance of work tasks might decrease the risk of developing dementia. A protective effect of enriched environment at work in general, namely high cognitive stimulation or confrontation with new tasks, could not be confirmed by the results.</p></div

Logistic Regression Models of the association between the occupational context indices and the incidence of dementia in individuals 75 years and older.

<p><i>Notes</i>^§model includes the predictor, age, and level of education;</p>#<p>model includes the predictor, age, level of education, gender, marital status, history of depression, and living situation;</p>*<p>complete model is significant at a p<0.01 level; OR, odds ratio/effect coefficient Exp(B); CI, confidence interval.</p

Demographics and occupational context indices for dementia-free participants and dementia cases.

<p>Demographics and occupational context indices for dementia-free participants and dementia cases.</p

Kaplan-Meier survival curves of depressive symptoms and major depression.

<p>Kaplan-Meier survival curves of depressive symptoms and major depression.</p

The risk of incident dementia during follow-up in 888 participants aged 75 years and older without dementia at baseline.

<p>Abbreviations: ADL – Activities of daily living; CES-D – Center for Epidemiologic Studies Depression Scale; CI – Confidence interval; IADL – Instrumental activities of daily living; MMSE – Mini Mental State Examination; SCID – Structured Clinical Interview; s.d. – standard deviation.</p><p>Notes:</p>1<p>Based on the revised version of the international CASMIN educational classification;</p>2<p>128 participants (14.4%) with depressive symptoms at baseline (CES-D cut-off score 23);</p>3<p>11 participants (1.2%) with major depression at baseline.</p

Characteristics of individuals with and without depressive symptoms and with and without major depression at baseline according to incident dementia diagnosis (n = 888).

<p>Characteristics of individuals with and without depressive symptoms and with and without major depression at baseline according to incident dementia diagnosis (n = 888).</p

Supplementary_File - Social Network Types in Old Age and Incident Dementia

<p>Supplementary_File for Social Network Types in Old Age and Incident Dementia by Francisca S. Rodriguez, Alexander Pabst, Tobias Luck, Hans-Helmut König, Matthias C. Angermeyer, A. Veronica Witte, Arno Villringer, and Steffi G. Riedel-Heller in Journal of Geriatric Psychiatry and Neurology</p

Comparison of inpatient rehabilitation participants and outpatient rehabilitation participants <b><i>before</i></b> rehabilitation.

<p>Calculations via Chi-square-tests and independent T-Tests;</p><p>SD: standard deviation; p: p-value;</p><p>IPR: inpatient rehabilitation; OPR: outpatient rehabilitation;</p><p>CIDI: Composite international diagnostic interview.</p><p>Cramer's V and Cohen's d as measures for effect sizes.</p><p>Significance level at 0.004 (0.05 divided by 14), bonferroni correction.</p

Binary logistic regression model of significant factors associated with the participation in outpatient rehabilitation^a (full model).

a<p>Reference category is the participation in inpatient rehabilitation.</p><p>* p<.05; Nagelkerke's R²–0.125.</p><p>B: Regression Coefficient B; OR: Odds Ratio; 95% CI: 95% Confidence Interval (OR); <i>p</i>: <i>p</i>-value; HADS: Hospital anxiety and depression scale; SF-36: Short Form 36; SPE: Subjective prognosis of gainful employment.</p

Repeated measure ANOVA for outcome variables with two assessment points.

<p>IPR: inpatient rehabilitation; OPR: outpatient rehabilitation.</p><p>SD: standard deviation; <i>p</i>: p-value; HADS: Hospital anxiety and depression scale; SF-36: Short Form 36; SPE: Subjective prognosis of gainful employment.</p><p>Partial Eta-squared (η_p²) as a measure for effect size.</p><p>Significance level at 0.007 (0.05 divided by 7), bonferroni correction.</p