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Original research
Cumulative exposure to psychosocial stressors at work and global cognitive function: the PROspective Quebec Study on Work and Health
  1. Caroline S. Duchaine1,2,3,4,5,
  2. Chantal Brisson1,2,3,4,5,
  3. Denis Talbot1,2,
  4. Mahée Gilbert-Ouimet1,6,
  5. Xavier Trudel1,2,3,4,
  6. Michel Vézina7,
  7. Alain Milot1,8,
  8. Caroline Diorio2,9,
  9. Ruth Ndjaboué2,4,
  10. Yves Giguère1,8,
  11. Benoît Mâsse10,
  12. Clermont E Dionne1,2,3,4,5,
  13. Elizabeth Maunsell1,2,
  14. Danielle Laurin1,3,4,5,11
  1. 1 Population Health and Optimal Health Practices Unit, CHU de Québec-Laval University Research Center, Québec, Québec, Canada
  2. 2 Social and Preventive Medicine, Laval University, Faculty of Medicine, Québec, Québec, Canada
  3. 3 Centre d’excellence sur le vieillissement de Québec, Québec, Québec, Canada
  4. 4 VITAM, Centre de recherche en santé durable, Québec, Québec, Canada
  5. 5 Institut sur le vieillissement et la participation sociale des aînés, Université Laval, Québec, Québec, Canada
  6. 6 Health Sciences, Université du Québec à Rimouski Campus de Lévis, Lévis, Québec, Canada
  7. 7 Institut national de santé publique du Québec, Québec, Québec, Canada
  8. 8 Medicine, Laval University, Faculty of medicine, Québec, Québec, Canada
  9. 9 Oncology, CHU de Québec-Université Laval Research Center, Québec, Québec, Canada
  10. 10 Médecine sociale et préventive, Université de Montréal, Montréal, Québec, Canada
  11. 11 Pharmacy, Laval University, Faculty of Pharmacy, Quebec, Quebec, Canada
  1. Correspondence to Dr Danielle Laurin, CHU de Québec-Laval University Research Center, Quebec, Canada; danielle.laurin{at}pha.ulaval.ca

Abstract

Objectives Psychosocial stressors at work have been proposed as modifiable risk factors for mild cognitive impairment (MCI). This study aimed to evaluate the effect of cumulative exposure to psychosocial stressors at work on cognitive function.

Methods This study was conducted among 9188 white-collar workers recruited in 1991–1993 (T1), with follow-ups 8 (T2) and 24 years later (T3). After excluding death, losses to follow-up and retirees at T2, 5728 participants were included. Psychosocial stressors at work were measured according to the Karasek’s questionnaire. Global cognitive function was measured with the Montreal Cognitive Assessment. Cumulative exposures to low psychological demand, low job control, passive job and high strain job were evaluated using marginal structural models including multiple imputation and inverse probability of censoring weighting.

Results In men, cumulative exposures (T1 and T2) to low psychological demand, low job control or passive job were associated with higher prevalences of more severe presentation of MCI (MSMCI) at T3 (Prevalence ratios (PRs) and 95% CIs of 1.50 (1.16 to 1.94); 1.38 (1.07 to 1.79) and 1.55 (1.20 to 2.00), respectively), but not with milder presentation of MCI. In women, only exposure to low psychological demand or passive job at T2 was associated with higher prevalences of MSMCI at T3 (PRs and 95% CI of 1.39 (0.97 to 1.99) and 1.29 (0.94 to 1.76), respectively).

Conclusions These results support the deleterious effect of a low stimulating job on cognitive function and the cognitive reserve theory. Psychosocial stressors at work could be part of the effort for the primary prevention of cognitive decline.

  • epidemiology
  • longitudinal studies
  • aging
  • occupational stress

Data availability statement

The data underlying this article cannot be shared publicly for the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author with permission of the Comité d’éthique de la recherche du CHU de Québec-Université Laval.

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Data availability statement

The data underlying this article cannot be shared publicly for the privacy of individuals that participated in the study. The data will be shared on reasonable request to the corresponding author with permission of the Comité d’éthique de la recherche du CHU de Québec-Université Laval.

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Footnotes

  • Contributors CB and DL were responsible for the study design, conception and the funding acquisiton. CDuc, MG-O, XT, MV, AM, CDio, RN, YG, BM, CED and EM contributed to the design and conception of the study and were implicated in the grant preparation. DT provideed expertise in data analysis and CDuc conducted the statistical analysis as part of her doctoral thesis. The first draft of the manuscript was written by CDuc. All authors commented on previous version of the manuscrit. All authors read and approved the final manuscript.

  • Funding This study was supported by the Canadian Institutes of Health Research (Grant numbers 201403MOP-32544-BCA-CFBA-52569, 201 309MOP-321916-Ph1-CFBA-35698 and 201810GSD-422016-DRB-CFBA-280487 to CDuc) and by the Fonds de Recherche du Québec—Santé (Grant numbers 35500 to CDuc and 265385 to DT).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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