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American Journal of Epidemiology Advance Access originally published online on February 7, 2008
American Journal of Epidemiology 2008 167(7):820-830; doi:10.1093/aje/kwm382
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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Is Complexity of Work Associated with Risk of Dementia?

The Canadian Study of Health and Aging

Edeltraut Kröger1,2, Ross Andel3, Joan Lindsay4, Zohra Benounissa2, René Verreault1,2 and Danielle Laurin2,5

1 Faculty of Medicine, Laval University, Quebec City, Quebec, Canada
2 Laval University Geriatrics Research Unit, Centre de recherche du CHA, Quebec City, Quebec, Canada
3 School of Aging Studies, University of South Florida, Tampa, FL
4 Department of Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada
5 Faculty of Pharmacy, Laval University, Quebec City, Quebec, Canada

Correspondence to Edeltraut Kröger, Laval University Geriatrics Research Unit, Hôpital du Saint-Sacrement, 1050, Chemin Sainte-Foy, Québec (QC) G1S 4L8, Canada (e-mail: Edeltraut.Kroger.cha{at}ssss.gouv.qc.ca).

Received for publication August 17, 2007. Accepted for publication December 4, 2007.

The authors evaluated the association of complexity of work with data, people, and things with the incidence of dementia, Alzheimer's disease, and vascular dementia in the Canadian Study of Health and Aging, while adjusting for work-related physical activity. The Canadian Study of Health and Aging is a 10-year population study, from 1991 to 2001, of a representative sample of persons aged 65 years or older. Lifetime job history allowed application of complexity scores and classification of work-related physical activity. Analyses included 3,557 subjects, of whom 400 were incident dementia cases, including 299 with Alzheimer's disease and 93 with vascular dementia. In fully adjusted Cox regression models, high complexity of work with people or things reduced risk of dementia (hazard ratios were 0.66 (95% confidence interval: 0.44, 0.98) and 0.72 (95% confidence interval: 0.52, 0.99), respectively) but not Alzheimer's disease. For vascular dementia, hazard ratios were 0.36 (95% confidence interval: 0.15, 0.90) for high complexity of work with people and 0.50 (95% confidence interval: 0.25, 1.00) for high complexity of work with things. Subgroup analyses according to median duration (23 years) of principal occupation showed that associations with complexity varied according to duration of employment. High complexity of work appears to be associated with risk of dementia, but effects may vary according to subtype.

Alzheimer disease; cohort studies; dementia; motor activity; occupations; risk factors; work

Abbreviations: CI, confidence interval; CSHA, Canadian Study of Health and Aging; WPA, work-related physical activity


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