Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve

Luca Kleineidam, Steffen Wolfsgruber, Anne-Sophie Weyrauch, Linn E Zulka, Simon Forstmeier, Sandra Roeske, Hendrik van den Bussche, Hanna Kaduszkiewicz, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Angela Fuchs, Michael Pentzek, Christian Brettschneider, Hans-Helmut König, Dagmar Weeg, Horst Bickel, Melanie Luppa, Francisca S Rodriguez, Silka Dawn FreieslebenSelin Erdogan, Chantal Unterfeld, Oliver Peters, Eike J Spruth, Slawek Altenstein, Andrea Lohse, Josef Priller, Klaus Fliessbach, Xenia Kobeleva, Anja Schneider, Claudia Bartels, Björn H Schott, Jens Wiltfang, Franziska Maier, Wenzel Glanz, Enise I Incesoy, Michaela Butryn, Emrah Düzel, Katharina Buerger, Daniel Janowitz, Michael Ewers, Boris-Stephan Rauchmann, Robert Perneczky, Ingo Kilimann, Doreen Görß, Stefan Teipel, Christoph Laske, Matthias H J Munk, Annika Spottke, Nina Roy, Frederic Brosseron, Michael T Heneka, Alfredo Ramirez, Renat Yakupov, Martin Scherer, Wolfgang Maier, Frank Jessen, Steffi G Riedel-Heller, Michael Wagner

Research output: Contribution to journalArticlepeer-review

Abstract / Description of output

INTRODUCTION: Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them.

METHODS: We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE).

RESULTS: Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.

DISCUSSION: Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.

Original languageEnglish
Pages (from-to)957308
JournalFrontiers in Psychology
Publication statusPublished - 8 Dec 2022


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