Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors

Hale, Jo Mhairi; Bijlsma, Maarten J.; Lorenti, Angelo

doi:10.1016/j.ssmph.2021.100855

Cited by 19 publications

(24 citation statements)

References 74 publications

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“…The association between retirement and functional impairment among women did was not robust. These observations are similar to results from a study in the USA that found differences in the retirement-cognitive decline association between men and women 43 . These findings might be, at least in part, due to women’s commonly low-status jobs and weaker attachment to the job market, particularly in SSA.…”

Section: Discussionsupporting

confidence: 89%

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Physical activity and gender buffer the association of retirement with functional impairment in Ghana

Gyasi

Amoah²,

Agyemang

et al. 2022

Sci Rep

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Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β = .76, p < .001) and in men (β = 1.96, p < .001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β = .71, p < .005; men: β = 1.86, p < .001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p < .005) and the ≥ 65 age group (β = −.43, p < .005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority.

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Section: Discussionsupporting

confidence: 89%

“…According to Hale et al. 43 , postponed retirement benefits cognitive function across diverse populations. However, our findings are inconsistent with previous studies suggesting better health outcomes during retirement 44 , 45 .…”

Section: Discussionmentioning

confidence: 99%

Physical activity and gender buffer the association of retirement with functional impairment in Ghana

Gyasi

Amoah²,

Agyemang

et al. 2022

Sci Rep

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“…We focused on the overall association between retirement age and cognitive impairment. It is presumed, however, that the consequences of working and retirement on later‐life health and cognition depends on many different individual, occupational and societal factors, 35 such as education, 36 psychosocial working conditions, 37 and the cognitive demands of the job 38,39 . Future research should explore whether there are particular subgroups for whom, or conditions under which, early or later retirement causally affects later‐life cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

Retirement age and disability status as pathways to later‐life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers

Zotcheva

Strand

Bowen³

et al. 2023

Int J Geriat Psychiatry

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Background Research shows that retirement age is associated with later‐life cognition but has not sufficiently distinguished between retirement pathways. We examined how retirement age was associated with later‐life dementia and mild cognitive impairment (MCI) for people who retired via the disability pathway (received a disability pension prior to old‐age pension eligibility) and those who retired via the standard pathway. Methods The study sample comprised 7210 participants from the Norwegian Trøndelag Health Study (HUNT4 70+, 2017–2019) who had worked for at least one year in 1967–2019, worked until age 55+, and retired before HUNT4. Dementia and MCI were clinically assessed in HUNT4 70+ when participants were aged 69–85 years. Historical data on participants' retirement age and pathway were retrieved from population registers. We used multinomial regression to assess the dementia/MCI risk for women and men retiring via the disability pathway, or early (<67 years), on‐time (age 67, old‐age pension eligibility) or late (age 68+) via the standard pathway. Results In our study sample, 9.5% had dementia, 35.3% had MCI, and 28.1% retired via the disability pathway. The disability retirement group had an elevated risk of dementia compared to the on‐time standard retirement group (relative risk ratio [RRR]: 1.64, 95% CI 1.14–2.37 for women, 1.70, 95% CI 1.17–2.48 for men). MCI risk was lower among men who retired late versus on‐time (RRR, 0.76, 95% CI 0.61–0.95). Conclusion Disability retirees should be monitored more closely, and preventive policies should be considered to minimize the dementia risk observed among this group of retirees.

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“…Conversely, multiple epidemiological studies in modern societies suggest that the abrupt loss of regular work-related cognitive stimulus due to retirement results in a parallel increase in the risk of cognitive decline. Even when adjusting for confounders that might explain both early retirement and cognitive decline such as comorbid medical conditions, those that retire earlier appear to experience ARCD sooner [ 11 , 12 , 141 ]. This effect is also greatest in those that have higher levels of education, where at a population level, work-related cognitive demand might be greatest and the decrease in cognitive demand after retirement might be most abrupt [ 140 ].…”

Section: Cognitive Demands Across the Lifespanmentioning

confidence: 99%

Demand Coupling Drives Neurodegeneration: A Model of Age-Related Cognitive Decline and Dementia

Turknett¹,

Wood

2022

Cells

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The societal burden of Alzheimer’s Disease (AD) and other major forms of dementia continues to grow, and multiple pharmacological agents directed towards modifying the pathological “hallmarks” of AD have yielded disappointing results. Though efforts continue towards broadening and deepening our knowledge and understanding of the mechanistic and neuropathological underpinnings of AD, our previous failures motivate a re-examination of how we conceptualize AD pathology and progression. In addition to not yielding effective treatments, the phenotypically heterogeneous biological processes that have been the primary area of focus to date have not been adequately shown to be necessary or sufficient to explain the risk and progression of AD. On the other hand, a growing body of evidence indicates that lifestyle and environment represent the ultimate level of causation for AD and age-related cognitive decline. Specifically, the decline in cognitive demands over the lifespan plays a central role in driving the structural and functional deteriorations of the brain. In the absence of adequate cognitive stimulus, physiological demand–function coupling leads to downregulation of growth, repair, and homeostatic processes, resulting in deteriorating brain tissue health, function, and capacity. In this setting, the heterogeneity of associated neuropathological tissue hallmarks then occurs as a consequence of an individual’s genetic and environmental background and are best considered downstream markers of the disease process rather than specific targets for direct intervention. In this manuscript we outline the evidence for a demand-driven model of age-related cognitive decline and dementia and why it mandates a holistic approach to dementia treatment and prevention that incorporates the primary upstream role of cognitive demand.

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Does postponing retirement affect cognitive function? A counterfactual experiment to disentangle life course risk factors

Cited by 19 publications

References 74 publications

Physical activity and gender buffer the association of retirement with functional impairment in Ghana

Physical activity and gender buffer the association of retirement with functional impairment in Ghana

Retirement age and disability status as pathways to later‐life cognitive impairment: Evidence from the Norwegian HUNT Study linked with Norwegian population registers

Demand Coupling Drives Neurodegeneration: A Model of Age-Related Cognitive Decline and Dementia

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