[en] [en] 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.
Disciplines :
Neurology
Author, co-author :
Kleineidam, Luca; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Wolfsgruber, Steffen; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Weyrauch, Anne-Sophie; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
Zulka, Linn E; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg, Gothenburg, Sweden
Forstmeier, Simon; Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
Roeske, Sandra; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
van den Bussche, Hendrik; Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Kaduszkiewicz, Hanna; Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany ; Medical Faculty, Institute of General Practice, University of Kiel, Kiel, Germany
Wiese, Birgitt; Center for Information Management, Hannover Medical School, Hanover, Germany
Weyerer, Siegfried; Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
Werle, Jochen; Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University, Heidelberg, Germany
Fuchs, Angela; Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
Pentzek, Michael; Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University, Düsseldorf, Germany
Brettschneider, Christian; Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
König, Hans-Helmut; Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Weeg, Dagmar; Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
Bickel, Horst; Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany
Luppa, Melanie; Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Rodriguez, Francisca S; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany ; Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Freiesleben, Silka Dawn; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany ; Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
Erdogan, Selin; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany ; Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
Unterfeld, Chantal; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany
Peters, Oliver; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Berlin, Germany ; Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC), Berlin, Germany
Spruth, Eike J; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
Altenstein, Slawek; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
Lohse, Andrea; Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany
Priller, Josef; Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich, Munich, Germany ; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany ; Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Berlin, Germany ; University of Edinburgh and UK DRI, Edinburgh, United Kingdom
Fliessbach, Klaus; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Kobeleva, Xenia; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Schneider, Anja; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Bartels, Claudia; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
Schott, Björn H; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany ; German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany ; Leibniz Institute for Neurobiology, Magdeburg, Germany
Wiltfang, Jens; Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany ; German Center for Neurodegenerative Diseases (DZNE), Goettingen, Germany ; Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal
Maier, Franziska; Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
Glanz, Wenzel; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
Incesoy, Enise I; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany ; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
Butryn, Michaela; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
Düzel, Emrah; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany ; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany
Buerger, Katharina; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
Janowitz, Daniel; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
Ewers, Michael; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
Rauchmann, Boris-Stephan; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
Perneczky, Robert; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany ; Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany ; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany ; Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London, London, United Kingdom ; Sheeld Institute for Translational Neuroscience (SITraN), University of Sheeld, Sheeld, United Kingdom
Kilimann, Ingo; German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany ; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
Görß, Doreen; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
Teipel, Stefan; German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany ; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
Laske, Christoph; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany ; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
Munk, Matthias H J; German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany ; Department of Biology, Technische Universität Darmstadt, Darmstadt, Germany
Spottke, Annika; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany ; Department of Neurology, University of Bonn, Bonn, Germany
Roy, Nina; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Brosseron, Frederic; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
HENEKA, Michael ; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
Ramirez, Alfredo; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany ; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany ; Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany ; Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
Yakupov, Renat; German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
Scherer, Martin; Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
Maier, Wolfgang; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
Jessen, Frank; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany ; Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany ; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
Riedel-Heller, Steffi G; Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
Wagner, Michael; Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany ; German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
This study was part of the German Research Network on Dementia (KND), the German Research Network on Degenerative Dementia (KNDD; German Study on Aging, Cognition, and Dementia in Primary Care Patients; AgeCoDe), and the Health Service Research Initiative [Study on Needs, health service use, costs, and health-related quality of life in a large sample of oldest-old primary care patients (85+; AgeQualiDe)] and was funded by the German Federal Ministry of Education and Research (grants KND: 01GI0102, 01GI0420, 01GI0422, 01GI0423, 01GI0429, 01GI0431, 01GI0433, and 01GI0434; grants KNDD: 01GI0710, 01GI0711, 01GI0712, 01GI0713, 01GI0714, 01GI0715, and 01GI0716; grants Health Service Research Initiative: 01GY1322A, 01GY1322B, 01GY1322C, 01GY1322D, 01GY1322E, 01GY1322F, and 01GY1322G).
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