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Older age at retirement is associated with decreased risk of dementia

  • NEUROEPIDEMIOLOGY
  • Published:
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Abstract

To test the hypothesis that age at retirement is associated with dementia risk among self-employed workers in France, we linked health and pension databases of self-employed workers and we extracted data of those who were still alive and retired as of December 31st 2010. Dementia cases were detected in the database either through the declaration of a long-term chronic disease coded as Alzheimer’s disease and other dementia (International Classification of Disease codes G30, F00, F01, F03) or through the claim for reimbursement of one of the anti-dementia drugs. Data were analyzed using Cox proportional hazard model adjusting for potential confounders. Among the 429,803 retired self-employed workers alive on December 31st 2010, prevalence of dementia was 2.65 %. Multivariable analyses showed that the hazard ratio of dementia was 0.968 [95 % confidence interval = (0.962–0.973)] per each extra year of age at retirement. After excluding workers who had dementia diagnosed within the 5 years following retirement, the results remained unchanged and highly significant (p < 0.0001). We show strong evidence of a significant decrease in the risk of developing dementia associated with older age at retirement, in line with the “use it or lose it” hypothesis. Further evidence is necessary to evaluate whether this association is causal, but our results indicate the potential importance of maintaining high levels of cognitive and social stimulation throughout work and retiree life.

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References

  1. Ngandu T, von Strauss E, Helkala EL, Winblad B, Nissinen A, Tuomilehto J, et al. Education and dementia: What lies behind the association? Neurology. 2007;69(14):1442–50.

    Article  CAS  PubMed  Google Scholar 

  2. Cohen CI. Education, occupation, and Alzheimer’s disease. JAMA. 1994;272:Letters 1405.

  3. Stern Y. Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord. 2006;20(Suppl 2):S69–74.

    Article  PubMed  Google Scholar 

  4. Cummings JL, Vinters HV, Cole GM, Khachaturian ZS. Alzheimer’s disease: etiologies, pathophysiology, cognitive reserve, and treatment opportunities. Neurology. 1998;51(Suppl 1):S2–17.

    Article  CAS  PubMed  Google Scholar 

  5. Staff RT, Murray AD, Deary IJ, Whalley LJ. What provides cerebral reserve? Brain. 2004;127:1191–9.

    Article  PubMed  Google Scholar 

  6. Stern Y. What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc. 2002;8(3):448–60.

    Article  PubMed  Google Scholar 

  7. Stern Y, Albert S, Tang MX, Tsai WY. Rate of memory decline in AD is related to education and occupation—Cognitive reserve? Neurology. 1999;53(9):1942–7.

    Article  CAS  PubMed  Google Scholar 

  8. Valenzuela MJ, Sachdev P. Brain reserve and dementia: a systematic review. Psychol Med. 2006;36(4):441–54. doi:10.1017/S0033291705006264.

    Article  PubMed  Google Scholar 

  9. Kroger E, Andel R, Lindsay J, Benounissa Z, Verreault R, Laurin D. Is complexity of work associated with risk of dementia? The Canadian Study of Health and Aging. Am J Epidemiol. 2008;167(7):820–30.

    Article  PubMed  Google Scholar 

  10. Potter GG, Helms MJ, Plassman BL. Associations of job demands and intelligence with cognitive performance among men in late life. Neurology. 2008;70(19 Pt 2):1803–8.

    PubMed  Google Scholar 

  11. Wilson RS, Bennett DA, Bienias JL, Aggarwal NT, de Leon CFM, Morris MC, et al. Cognitive activity and incident AD in a population-based sample of older persons. Neurology. 2002;59(12):1910–4.

    Article  CAS  PubMed  Google Scholar 

  12. Boyle PA, Buchman AS, Wilson RS, Yu L, Schneider JA, Bennett DA. Effect of purpose in life on the relation between Alzheimer disease pathologic changes on cognitive function in advanced age. Arch Gen Psychiatry. 2012;69(5):499–505. doi:10.1001/archgenpsychiatry.2011.1487.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Valenzuela MJ, Sachdev P, Wen W, Chen X, Brodaty H. Lifespan mental activity predicts diminished rate of hippocampal atrophy. PLoS One. 2008;3(7):e2598. doi:10.1371/journal.pone.0002598.

    Article  PubMed Central  PubMed  Google Scholar 

  14. Gates NJ, Valenzuela M, Sachdev PS, Singh NA, Baune BT, Brodaty H, et al. Study of Mental Activity and Regular Training (SMART) in at risk individuals: a randomised double blind, sham controlled, longitudinal trial. BMC Geriatr. 2011;11:19. doi:10.1186/1471-2318-11-19.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Sitzer DI, Twamley EW, Jeste DV. Cognitive training in Alzheimer’s disease: a meta-analysis of the literature. Acta Psychiatr Scand. 2006;114(2):75–90. doi:10.1111/j.1600-0447.2006.00789.x.

    Article  CAS  PubMed  Google Scholar 

  16. Unverzagt FW, Guey LT, Jones RN, Marsiske M, King JW, Wadley VG, et al. ACTIVE cognitive training and rates of incident dementia. J Int Neuropsychol Soc. 2012;18(4):669–77. doi:10.1017/S1355617711001470.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Coe NB, von Gaudecker HM, Lindeboom M, Maurer J. The effect of retirement on cognitive functioning. Health Econ. 2012;21(8):913–27. doi:10.1002/hec.1771.

    Article  PubMed  Google Scholar 

  18. Brookmeyer R, Gray S, Kawas C. Projections of Alzheimer’s disease in the United States and the public health impact of delaying disease onset. Am J Public Health. 1998;88(9):1337–42.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  19. Bonsang E, Adam S, Perelman S. Does retirement affect cognitive functioning? J Health Econ. 2012;31(3):490–501. doi:10.1016/j.jhealeco.2012.03.005.

    Article  PubMed  Google Scholar 

  20. Lupton MK, Stahl D, Archer N, Foy C, Poppe M, Lovestone S, et al. Education, occupation and retirement age effects on the age of onset of Alzheimer’s disease. Int J Geriatr Psychiatry. 2010;25(1):30–6. doi:10.1002/gps.2294.

    PubMed  Google Scholar 

  21. Roberts BA, Fuhrer R, Marmot M, Richards M. Does retirement influence cognitive performance? The Whitehall II Study. J Epidemiol Community Health. 2011;65(11):958–63. doi:10.1136/jech.2010.111849.

    Article  PubMed  Google Scholar 

  22. Rohwedder S, Willis RJ. Mental retirement. J Econ Perspect. 2010;24(1):119–38. doi:10.1257/jep.24.1.119.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Bamia C, Trichopoulou A, Trichopoulos D. Age at retirement and mortality in a general population sample: the Greek EPIC Study. Am J Epidemiol. 2008;167(5):561–9. doi:10.1093/aje/kwm337.

    Article  PubMed  Google Scholar 

  24. Hammerman-Rozenberg R, Maaravi Y, Cohen A, Stessman J. Working late: the impact of work after 70 on longevity, health and function. Aging Clin Exp Res. 2005;17(6):508–13.

    Article  PubMed  Google Scholar 

  25. Gallo WT, Teng HM, Falba TA, Kasl SV, Krumholz HM, Bradley EH. The impact of late career job loss on myocardial infarction and stroke: a 10 year follow up using the health and retirement survey. Occup Environ Med. 2006;63(10):683–7. doi:10.1136/oem.2006.026823.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012;11(11):1006–12. doi:10.1016/S1474-4422(12)70191-6.

    Article  PubMed Central  PubMed  Google Scholar 

  27. Driscoll I, Troncoso J. Asymptomatic Alzheimer’s disease: A prodrome or a state of resilience? Curr Alzheimer Res. 2011;8(4):330–5.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  28. Valenzuela M, Sachdev P. Can cognitive exercise prevent the onset of dementia? Systematic review of randomized clinical trials with longitudinal follow-up. Am J Geriatr Psychiatry. 2009;17(3):179–87. doi:10.1097/JGP.0b013e3181953b57.

    Article  PubMed  Google Scholar 

  29. Bertrand M, Tzourio C, Alperovitch A. Trends in recognition and treatment of dementia in France. Analysis of the 2004–2010 database of the national health insurance plan. Alzheimer Dis Assoc Disord. 2013;27(3):213–7. doi:10.1097/WAD.0b013e3182695a3b.

    Article  PubMed  Google Scholar 

  30. Ramaroson H, Helmer C, Barberger-Gateau P, Letenneur L, Dartigues JF. Prevalence of dementia and Alzheimer’s disease among subjects aged 75 years or over: updated results of the PAQUID cohort. Rev Neurol (Paris). 2003;159(4):405–11.

    CAS  Google Scholar 

  31. Matthews FE, Arthur A, Barnes LE, Bond J, Jagger C, Robinson L, Brayne C. Medical Research Council Cognitive Function and Ageing Collaboration. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013;382(9902):1405–12. doi:10.1016/S0140-6736(13)61570-6.

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This study was initiated by ILC-France and supported by funds provided by Ipsen Pharma, Van Dyck Health Care, Groupe PREVOIR, Lündbeck SAS, Nutricia Nutrition Clinique (groupe Danone), HSBC France. The funding sources had no role in study design, data collection, analysis, interpretation, or writing of the report.

Conflict of interest

The authors declare that no competing interests exist.

Author information

Authors and Affiliations

  1. Centre INSERM U897-Epidemiologie-Biostatistique and CIC-EC7, INSERM, ISPED, 33000, Bordeaux, France

    Carole Dufouil, Edwige Pereira & Geneviève Chêne

  2. Centre INSERM U897-Epidemiologie-Biostatistique, ISPED, Univ. Bordeaux, 33000, Bordeaux, France

    Carole Dufouil, Edwige Pereira, Geneviève Chêne & Annick Alpérovitch

  3. Pôle de Santé Publique, CHU de Bordeaux, 33000, Bordeaux, France

    Carole Dufouil & Geneviève Chêne

  4. Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA

    M. Maria Glymour

  5. Régime Social des Indépendants, 33000, Bordeaux, France

    Elodie Saubusse

  6. Régime Social des Indépendants, 93200, Saint-Denis, France

    Mathilde Risse-Fleury

  7. Agence Nationale de sécurité du médicament et des produits de santé, 93200, Saint-Denis, France

    Brigitte Heuls

  8. International Longevity Centre-France, 75016, Paris, France

    Jean-Claude Salord, Marie-Anne Brieu & Françoise Forette

  9. University René Descartes, 75005, Paris, France

    Françoise Forette

  10. INSERM U897 and CIC-EC7, Bâtiment ISPED-Université de Bordeaux, 146 rue Léo Saignat, 33076, Bordeaux Cédex, France

    Carole Dufouil

Authors
  1. Carole Dufouil
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  2. Edwige Pereira
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  3. Geneviève Chêne
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  4. M. Maria Glymour
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  6. Elodie Saubusse
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  7. Mathilde Risse-Fleury
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  8. Brigitte Heuls
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  9. Jean-Claude Salord
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  11. Françoise Forette
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Correspondence to Carole Dufouil.

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Dufouil, C., Pereira, E., Chêne, G. et al. Older age at retirement is associated with decreased risk of dementia. Eur J Epidemiol 29, 353–361 (2014). https://doi.org/10.1007/s10654-014-9906-3

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  • DOI: https://doi.org/10.1007/s10654-014-9906-3

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