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Article type: Research Article
Authors: Hyun, Jinshila; * | Hall, Charles B.a; b | Sliwinski, Martin J.c | Katz, Mindy J.a | Wang, Cuilinga; b | Ezzati, Alia | Lipton, Richard B.a
Affiliations: [a] Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA | [b] Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [c] Department of Human Development and Family Studies and Center for Healthy Aging, Pennsylvania State University, University Park, PA, USA
Correspondence: [*] Correspondence to: Jinshil Hyun, PhD, Department of Neurology, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Bronx, NY 10461, USA. Tel.: +1 718 839 7605; E-mail: jinshil.hyun@einsteinmed.org.
Abstract: Background:Engaging in mentally challenging activities may protect against dementia in late life. However, little is known whether the association between mentally challenging activities and dementia risk varies with race/ethnicity. Objective:The current study investigates whether having jobs with higher mental stimulation is differentially associated with a decreased risk of dementia between African Americans (AAs) and non-Hispanic Whites (nHWs). Methods:The sample consisted of 1,079 individuals (66% nHWs, 28% AAs; age = 78.6±5.3) from the longitudinal Einstein Aging Study. Occupation information of each participant was collected retrospectively at baseline and was linked to the substantive complexity of work score from the Dictionary of Occupational Titles. Cox proportional hazards models were used to evaluate the associations of occupational complexity with risk of dementia. Results:Individuals whose jobs had moderate-to-high levels of complexity, compared to those with the lowest complexity, were at modestly decreased risk for incident dementia. When stratified by race, moderate-to-high levels of occupational complexity were significantly associated with lower risk of developing dementia for AAs (HR = 0.35). When risk of dementia was evaluated based on the combinations of race×occupational complexity, AAs with lowest occupational complexity showed the highest risk of developing dementia, while other combinations exhibited lower risk of developing dementia (HRs = 0.36~0.43). Conclusion:Our results suggest that moderate-to-high levels of complexity at work are associated with a decreased risk of incident dementia in AAs. Understanding the differential effects of mentally challenging occupations across race/ethnicity may suggest important intervention strategies that could mitigate racial disparities in dementia rates.
Keywords: African Americans, dementia, occupations, race, workplace
DOI: 10.3233/JAD-191222
Journal: Journal of Alzheimer's Disease, vol. 75, no. 4, pp. 1405-1416, 2020
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