Hans Bosma

Job strain, effort-reward imbalance and employee well-being: a large-scale cross-sectional study

This study investigated the effects of the Job Demand-Control (JD-C) Model and the Effort-Reward Imbalance (ERI) Model on employee well-being. A cross-sectional survey was conducted comprising a large representative sample of 11,636 employed Dutch men and women. Logistic regression analyses were used. Controlling for job sector, demographic characteristics (including educational level) and managerial position, employees reporting high job demands (i.e. psychological and physical demands) and low job control had elevated risks of emotional exhaustion, psychosomatic and physical health complaints and job dissatisfaction (odds ratios ranged from 2.89 to 10.94). Odds ratios were generally higher in employees reporting both high (psychological and physical) efforts and low rewards (i.e. poor salary, job insecurity and low work support): they ranged from 3.23 to 15.43. Furthermore, overcommitted people had higher risks of poor well-being due to a high effort-low reward mismatch (ORs: 3.57-20.81) than their less committed counterparts (ORs: 3.01-12.71). Finally, high efforts and low occupational rewards were stronger predictors of poor well-being than low job control when both job stress models were simultaneously adjusted. In conclusion, our findings show independent cumulative effects of both the JD-C Model and the ERI Model on employee well-being and are not significantly different in men and women as well as in young and old people. In particular, high (psychological and physical) efforts and low rewards adversely affected employee well-being. Preliminary findings also indicate excess risks of poor well-being in overcommitted persons suffering from high cost--low gain conditions at work.

Change in Sensory Functioning Predicts Change in Cognitive Functioning: Results from a 6-Year Follow-Up in the Maastricht Aging Study

Objectives: To examine the longitudinal relationship between sensory functioning and a broad range of cognitive functions after 6 years follow‐up and whether cataract surgery or first‐time hearing aid use affected cognition.

Cognitive functioning in healthy older adults aged 64-81: a cohort study into the effects of age, sex, and education.

ABSTRACT The objective of this study was to determine a possible differential effect of age, education, and sex on cognitive speed, verbal memory, executive functioning, and verbal fluency in healthy older adults. A group of 578 healthy participants in the age range of 64–81 was recruited from a large population study of healthy adults (Maastricht Aging Study). Even in healthy individuals in this restricted age range, there is a clear, age-related decrease in performance on executive functioning, verbal fluency, verbal memory, and cognitive speed tasks. The capacity to inhibit information is affected most. Education had a substantial effect on cognitive functioning: participants with a middle or high level of education performed better on cognitive tests than did participants with a low level of education. Women performed better than men on verbal memory tasks. Therefore, education and sex must be taken into account when examining an older individuals cognitive performance.

Social class in childhood and general health in adulthood: Questionnaire study of contribution of psychological attributes.

Objective: To determine the contribution of psychological attributes (personality characteristics and coping styles) to the association between social class in childhood and adult health among men and women. Design: Partly retrospective, partly cross sectional study conducted in the framework of the Dutch GLOBE study. Subjects: Sample of general population from south east Netherlands consisting of 2174men and women aged 25-74years. Baseline self reported data from 1991provided information on childhood and adult social class, psychological attributes, and general health. Main outcome measure: Self rated poor health. Results: Independent of adult social class, low childhood social class was related to self rated poor health (odds ratio 1.67(95% confidence interval 1.02to 2.75) for subjects whose fathers were unskilled manual workers versus subjects whose fathers were higher grade professionals). Subjects whose fathers were manual workers generally had more unfavourable personality profiles and more negative coping styles. External locus of control, neuroticism, and the absence of active problem focused coping explained about half of the association between childhood social class and self rated poor health. The findings were independent of adult social class and height. Conclusions: A higher prevalence of negative personality profiles and adverse coping styles in subjects who grew up in lower social classes explains part of the association between social class in childhood and adult health. This finding underlines the importance of psychological mechanisms in the examination of the negative effects of adverse socioeconomic conditions in childhood.

Socioeconomic inequalities in mortality and importance of perceived control: cohort study.

Perceived control has convincingly been suggested to be a key concept in explaining socioeconomic differences in health.1 Some empirical evidence exists of a higher prevalence of low control beliefs (such as powerlessness or fatalism) in lower socioeconomic groups and that this is relevant to socioeconomic inequalities in general health.2 However, a systematic examination of the extent to which perceived control contributes to socioeconomic inequalities in mortality is lacking. This is important, as attention has recently shifted towards psychological and psychosocial explanations of socioeconomic inequalities in health. Data were collected in 1991 within the framework of a general population study of the health and living conditions of the population of Eindhoven and its surroundings (the GLOBE study).3 We invited a random subsample for interview. The response rate was 80% and not related to demographic characteristics. Interviewdata were available for 1220 men and 1242 women aged 25-74 (51 on …

Summed score of the Patient Health Questionnaire-9 was a reliable and valid method for depression screening in chronically ill elderly patients

OBJECTIVE To assess the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) as a screening instrument for depression in elderly patients with diabetes mellitus (DM) and chronic obstructive pulmonary disease (COPD) without known depression. STUDY DESIGN AND SETTING DM and COPD patients aged >59 years were selected from general practices. A test-retest was conducted in 105 patients. Criterion validity, using the Mini International Neuropsychiatric Interview psychiatric interview to diagnose major depressive disorder (MDD) and any depressive disorder (ADD) as diagnostic standard, was evaluated for both summed and algorithm-based PHQ-9 score in 713 patients. Correlations with quality of life and severity of illness were calculated to assess construct validity. RESULTS Cohens kappa for the algorithm-based score was 0.71 for MDD and 0.69 for ADD. Correlation for test-retest assessment of the summed score was 0.91. The algorithm-based score had low sensitivity and high specificity, but both sensitivity and specificity were high for the optimal cut-off point of 6 on the summed score for ADD (Se 95.6%, Sp 81.0%). Correlations between summed score and quality of life and severity of illness were acceptable. CONCLUSION The summed PHQ-9 score seems a valid and reliable screening instrument for depression in elderly primary care patients with DM and COPD.

Mental work demands protect against cognitive impairment: MAAS prospective cohort study.

Little is known about whether persons with mentally demanding jobs are protected against cognitive impairment and whether this association is independent of intellectual abilities and other confounders. Longitudinal data from the Maastricht Aging Study (MAAS) were used to examine this association. After the 1993-1995 baseline examination, there was a first 3-year follow-up examination (1996-1998) among 630 men and women, aged 50 to 80, who exhibited no cognitive impairment at baseline. Persons with mentally demanding jobs had lower risks of developing cognitive impairment during follow-up (36 cases), compared with persons without such jobs (odds ratio = 0.79; 95% confidence interval: 0.65-0.96). About 1.5% of the persons with high mental work demands developed impairment compared to 4% of the persons with few work demands. The protective effect was independent of intellectual abilities and other confounders. Our findings provide evidence that continued and potentially modifiable mental stimulation during adult life may protect men and women against cognitive impairment.

The effects of habitual caffeine use on cognitive change: a longitudinal perspective

The efficiency of higher cortical functions, such as memory and speed of complex information processing, tends to decrease with advancing age in normal healthy individuals. Recently, a high habitual intake of caffeine was found associated with better verbal memory performance and psychomotor speed in several cross-sectional population studies. We tested the hypothesis that habitual caffeine intake can reduce or postpone age-related cognitive decline in healthy adults. For this purpose, the cognitive performance of all participants in the Maastricht Aging Study (MAAS), aged between 24 and 81 years, was reassessed after 6 years. Information on the intake of caffeine-containing beverages was available from the baseline questionnaire. After 6 years, 1376 (75.6%) individuals were available for reassessment. After correction for demographic characteristics, baseline performance and health status, there were small albeit significant associations between the overall estimated caffeine intake at baseline and the 6-year change in complex motor speed (motor choice reaction time). The earlier found association between caffeine intake and verbal memory performance was not apparent in this longitudinal study. These results imply that the longitudinal effect of habitual caffeine intake is limited and will not promote a substantial reduction in age-related cognitive decline at a population level.

Engaged lifestyle and cognitive function in middle and old-aged, non-demented persons: a reciprocal association?

Summary. Some studies have shown that cognitive function is positively affected by an engaged and active lifestyle. However, a recent study found evidence for an opposite causal direction, i.e., persons with good cognitive function more often start to engage in leisure-time activities. Here, we longitudinally examine the causal direction of the association between an engaged lifestyle and cognitive function in middle and old-aged Dutch men and women.    The participants in the prospective cohort study “Maastricht Aging Study” (MAAS) were recruited from a register of 15 family practices in the South of the Netherlands. There were 830 non-demented men and women, aged 49 to 81 in 1993–1995 (baseline phase). They were re-examined three years later (follow-up phase). During both phases, all persons reported on their participation in mental, social, and physical activities. Six separate neuropsychological tests, including the Mini-Mental State Examination, were used to define cognitive function at baseline and follow-up.    All three activities measured were negatively related to cognitive decline between both phases. Effects were moderate, but consistent. Persons participating in all three activities were particularly protected against longitudinal decline. Furthermore, persons with the best baseline cognitive performance were more likely to increase their number of activities during follow-up compared with persons with the poorest scores.    In summary, an engaged lifestyle and cognitive function mutually influence each other in middle and old aged, non-demented persons. This reciprocal association is characterized by simultaneous positive effects of leisure-time activities and good cognitive function on cognitive function and leisure-time activities, respectively. This reciprocal association may create a self-reinforcing, beneficial or adverse life-course in middle and old age.Zusammenfassung. Verschiedene Untersuchungen haben ergeben, dass ein engagierter Lebensstil die kognitive Funktion positiv beeinflusst. Jedoch, eine rezente Untersuchung hat eine entgegengesetzte kausale Richtung dargestellt, d.h. dass Personen, die gut kognitiv funktionieren, häufiger und früher Freizeitaktivitäten entwickeln. In dieser Studie haben wir den kausalen Zusammenhang zwischen einem aktiven Lebensstil und der kognitiven Funktion bei älteren und alten niederländischen Männern und Frauen erforscht.   Für diese prospektive Kohorten-Untersuchung „Maastricht Aging Study (MAAS)“ entnahmen wir die Teilnehmernamen einem ärztlichen Register von 15 Praxen im Süden der Niederlande. In den Jahren 1993–1995 untersuchten wir 830 nicht-demente Männer und Frauen im Altersbereich von 49–81 Jahren (erste Phase). Nach drei Jahren wurde die Untersuchung wiederholt (zweite Phase). In beiden Phasen wurden die Personen um ihre mentalen, sozialen und physischen Aktivitäten befragt. Damit das kognitive Funktionieren in der ersten und zweiten Phase festgestellt werden konnte, verwendeten wir sechs unterschiedliche neuropsychologische Tests, einschließlich der Mini Mental State Examination.    Die drei untersuchten Aktivitäten beeinträchtigten, jede für sich die kognitive Leistung zwischen den beiden Phasen. Die Effekte waren zwar bescheiden, aber konsistent. Die Personen, die alle drei Aktivitäten ausübten, waren besonders vor kognitiver Beeinträchtigung geschützt. Die Personen, die ihre Aktivitäten zwischen der ersten und zweiten Phase erweitern, waren auch diejenigen, die in der ersten Phase am besten kognitiv funktionierten.    Kurz gefasst, ein aktiver Lebensstil und die kognitive Funktion beeinflussen sich bei nicht dementen Personen mittleren und höheren Alters gegenseitig und im positiven Sinne. Diese reziproke Assoziation wird durch simultane, positive Effekte von Freizeitaktivitäten auf die kognitive Funktion einerseits, und von der kognitiven Funktion auf die Freizeitaktivitäten andererseits charakterisiert. Diese reziproke Assoziation kann bewirken, dass sich – sich selbst verstärkend – ein positiver oder aber ungünstiger Lebensverlauf in mittlerem und höherem Alter entwickelt.

Associations between lifestyle and depressed mood: Longitudinal results from the Maastricht Aging Study

OBJECTIVES We examined whether healthy lifestyles are associated with absence of depressed mood. METHODS A sample of 1169 adult participants in the Maastricht Aging Study provided baseline and 6-year follow-up data on smoking, alcohol use, physical exercise, body mass index, and mood. We examined associations between lifestyles and depressed mood using longitudinal analyses controlling for baseline depressive symptoms and covariates. RESULTS Reports of excessive alcohol use at baseline predicted depressed mood at follow-up (relative risk [RR] = 2.48; 95% confidence interval [CI] = 1.08, 5.69), and reports of more than 30 minutes of physical exercise per day at baseline were associated with an absence of depressed mood at follow-up (RR=0.52; 95% CI=0.29, 0.92). Reports of being engaged in physical exercise throughout the 6-year follow-up period were also associated with absence of depressed mood (RR=0.56; 95% CI=0.34, 0.93). CONCLUSIONS In this relatively healthy population sample, certain lifestyles either predicted or protected against depressed mood. Adopting or maintaining healthy lifestyles might be a starting point in preventing or treating depressed mood over time.