Objectives To investigate the association between job strain and subsequent cognitive change over approximately 11 years, using data from the population-based Baltimore Epidemiologic Catchment Area follow-up study.
Methods The sample ranged from 555 to 563 participants, depending on the outcome, who reported psychosocial characteristics corresponding to the full-time job they held at baseline (1993–1996). Overall cognitive performance was measured by the Mini-Mental State Examination (MMSE), and verbal memory was measured by the ImmediateWord Recall Task and Delayed Word Recall Task at baseline and follow-up (2004–2005). Multiple linear regression was used to examine the association between job strain and cognitive change, and inverse probability weighting was used to account for differential attrition.
Results Participants with high job demands (psychological or physical demands) and/or low job control had greater decrease in the MMSE and memory scores than those with low job demands and high job control. After adjustment for baseline outcome scores, age and sex, the greatest decrease was observed in participants with high job demands and low job control (MMSE: −0.24, 95% CI −0.36 to –0.11; verbal memory scores: −0.26, 95% CI −0.44 to –0.07). The differences were partially explained by sociodemographic characteristics, occupational prestige and health factors.
Conclusions Findings from this prospective study suggest that job strain is associated with and may be a potential modifiable risk factor for adverse cognitive outcomes.
- mental health
- public health
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Contributors LD conceived the research question, conducted data analyses and drafted the manuscript. APS, JA and RM contributed to the study design, data interpretation, revision of the manuscript and the final approval. WWE provided the data, and contributed to the study design and the final approval. PJS contributed to revision of the manuscript and the final approval. RM supervised the project.
Funding This work was supported by the National Institute on Aging at the National Institutes of Health (grant number U01AG052445 to APS and WWE).
Competing interests None declared.
Patient consent Not required.
Ethics approval The Baltimore ECA follow-up study was approved by the Institutional Review Board of the Johns Hopkins Bloomberg School of Public Health.
Provenance and peer review Not commissioned; externally peer reviewed.