Charlotta Nilsen

Midlife Work-Related Stress Increases Dementia Risk in Later Life: The CAIDE 30-Year Study

Objective To investigate the associations between midlife work-related stress and mild cognitive impairment (MCI), dementia, and Alzheimers disease later in life, in a large representative population. Method Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study participants were randomly selected from independent population-based surveys (mean age 50 years). A random sample of 2,000 individuals was invited for two reexaminations including cognitive tests (at mean age 71 and mean age 78), and 1,511 subjects participated in at least one reexamination (mean follow-up 28.5 years). Work-related stress was measured using two questions on work demands that were administered in midlife. Analyses adjusted for important confounders. Results Higher levels of midlife work-related stress were associated with higher risk of MCI (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.08-1.76), dementia (OR, 1.53; CI, 1.13-2.07), and Alzheimers disease (OR, 1.55; CI, 1.19-2.36) at the first follow-up among the CAIDE participants. Results remained significant after adjusting for several possible confounders. Work-related stress was not associated with MCI and dementia during the extended follow-up. Discussion Midlife work-related stress increases the risk for MCI, dementia, and Alzheimers disease in later life. The association was not seen after the extended follow-up possibly reflecting selective survival/participation, heterogeneity in dementia among the oldest old, and a critical time window for the effects of midlife stress.

Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age : a longitudinal study with over 20 years of follow-up

BackgroundPeople spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age.MethodsData from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20–24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems).ResultsWhile not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among men. Job control was negatively associated with serious health problems. The strongest association in this study was between high job strain and complex health problems. After adjustment for educational attainment some of the associations became statistically nonsignificant. However, high job demands, remained related to lower odds of serious problems in one health domain among men, and low job control remained associated with higher odds of complex health problems among men. High job demands were associated with lower odds of complex health problems among men with low education, but not among men with high education, or among women regardless of level of education.ConclusionsThe results underscore the importance of work-related stress for long-term health. Modification to work environment to reduce work stress (e.g., providing opportunities for self-direction/monitoring levels of psychological job demands) may serve as a springboard for the development of preventive strategies to improve public health both before and after retirement.

The association between mid-life socioeconomic position and health after retirement--exploring the role of working conditions.

Objective: To explore the role of working conditions in the association between socioeconomic position and health after retirement age using over 20 years follow-up. Method: Two Swedish nationally representative Level of Living Surveys (total N = 1,131) were used. Ordered logistic regression was used to assess the association between socioeconomic position and health (self-rated health, psychological distress, musculoskeletal pain, circulatory problems, physical and cognitive impairment). The role of physical and psychological working conditions was also assessed. Results: Lower socioeconomic position was associated with more adverse physical, but not psychological, working conditions. Physical working conditions partially explained the differences in physical impairment and musculoskeletal pain in old age attributed to socioeconomic position, but not differences in self-rated health, circulatory problems, psychological distress, and cognitive impairment. Socioeconomic position was a stronger correlate of health than psychological working conditions alone. Discussion: Improving physical working conditions may be important for reducing the influence of socioeconomic position on health after retirement.

Work-related stress in midlife and all-cause mortality: can sense of coherence modify this association?

BACKGROUND Survival reflects the accumulation of multiple influences experienced over the life course. Given the amount of time usually spent at work, the influence of work may be particularly important. We examined the association between work-related stress in midlife and subsequent mortality, investigating whether sense of coherence modified the association. METHODS Self-reported work-related stress was assessed in 1393 Swedish workers aged 42-65 who participated in the nationally representative Level of Living Survey in 1991. An established psychosocial job exposure matrix was applied to measure occupation-based stress. Sense of coherence was measured as meaningfulness, manageability and comprehensibility. Mortality data were collected from the Swedish National Cause of Death Register. Data were analyzed with hazard regression with Gompertz distributed baseline intensity. RESULTS After adjustment for socioeconomic position, occupation-based high job strain was associated with higher mortality in the presence of a weak sense of coherence (HR, 3.15; 1.62-6.13), a result that was stronger in women (HR, 4.48; 1.64-12.26) than in men (HR, 2.90; 1.12-7.49). Self-reported passive jobs were associated with higher mortality in the presence of a weak sense of coherence in men (HR, 2.76; 1.16-6.59). The link between work stress and mortality was not significant in the presence of a strong sense of coherence, indicating that a strong sense of coherence buffered the negative effects of work-related stress on mortality. CONCLUSIONS Modifications to work environments that reduce work-related stress may contribute to better health and longer lives, especially in combination with promoting a sense of coherence among workers.

Work Stressors in Late Midlife and Physical Functioning in Old Age

Objective: The aim of this study was to explore the relationship between work stressors in late midlife and physical functioning in old age. Method: Two linked nationally representative Swedish surveys were used: the 1991 Level of Living Survey (age 57-65) and the 2011 Swedish Panel Study of Living Conditions of the Oldest Old. Work stressors were measured with the job demand–control model and physical functioning in old age with physical performance tests, lung function tests, and self-reported mobility. Ordered logistic and linear regressions were performed (n = 166-214). Results: High demands, low control, and high strain (i.e., high demands combined with low control) were associated with limited physical functioning in women. Low control and passive jobs were associated with limited physical functioning in men. Discussion: Work stressors in late midlife are important predictors of physical functioning in older adults. However, women and men seem to be vulnerable to different work stressors.

Does the association between leisure activities and survival in old age differ by living arrangement

Background Government policies to promote ageing in place have led to a growing frail population living at home in advanced old age, many of whom live alone. Living alone in old age is associated with adverse health outcomes, but we know little about whether it moderates the health impact of other risk and protective factors. Engagement in leisure activities is considered critical to successful ageing. We investigated whether the association between different types of leisure activities and survival in non-institutionalised older adults (aged 76 and above) differs by living arrangement and gender. Methods We used the Swedish Panel Study of Living Conditions of the Oldest Old study from 2011 and the Swedish Cause of Death Register (until 30 June 2014) to conduct Cox regression analyses (n=669). Incident mortality was 30.2% during the follow-up period. Results Overall level of leisure activity was not significantly associated with survival in either living arrangement, but some specific leisure activities, and associations, were different across gender and living arrangement. More specifically, certain social activities (participation in organisations and having relatives visit) were associated with longer survival, but only in men living alone. In women, most results were statistically non-significant, with the exception of solving crosswords being associated with longer survival in women living with someone. Conclusion In order to facilitate engagement with life, interventions focusing on leisure activities in the oldest age groups should take gender and living arrangement into consideration when determining the type of activity most needed.

Are socioeconomic position, work stress, and work complexity associated to mobility after retirement?

Are socioeconomic position, work stress, and work complexity associated to mobility after retirement?Abstracts from the ICBM 2014 Meetings from the ICBM 2014 MeetingIntroduction: Attitudinal ambivalence occurs when individuals endorse both positive and negative attitudes toward the same target object. Ambivalent attitudes are particularly relevant for addictive behaviours, as these behaviours may have both positive and negative evaluations associated with them. For example, drinking alcohol may make someone relaxed but can also produce feelings of nausea. Despite this, the majority of research focused on attitudes toward addictive behaviours assume that these attitudes are either positive or negative, not positive and negative. By assessing ambivalence toward addictive behaviours, a greater understanding of the nature of attitudes underlying these behaviours can be realised. Method: A total of 247 participants (M= 28.76 years) took part in this study. A measure of potential ambivalence, which asks participants to indicate their positive and negative evaluations on split semantic differential scales, was completed for five different health behaviours: drinking on a weekday and a weekend, exercising, increasing fruit and vegetable intake and smoking. Results: Attitudes toward alcohol consumption were found to be the most ambivalent. When examining drinking behaviour, a pattern emerged suggesting that the greater the quantity of alcohol consumed, the more ambivalent participants were toward drinking. Similar patterns were found for smoking. Conclusions: The results suggest that attitudinal ambivalence is an important aspect of addictive behaviours, as participants engaging in greater levels of these behaviours also reported higher levels of ambivalence. This indicates that individuals are aware of the positives and negatives of addictive behaviours but continue to perform them anyway.Salivary cortisol and alpha-amylase (sAA) that reflect hypothalamopituitary-adrenal axis (HPA-axis) activity and sympathetic activity within the autonomic nervous system (ANS) respectively, are bio ...Introduction: Previous research has developed an 11-item self-report measure assessing activation and pressure stress among adolescents. However, the biological correlates of this measure are uncle ...