Cognitive decline and dementia are major burden for our aging society. The pathological processes implicated in dementia seem to be active many years before the first clinical signs. The life-course approach aims to integrate the different biological, social, clinical, psychological, and environmental components that interact all along the lifetime of a person, factors which are major determinants of our cognitive aging. Some studies illustrate how occupation and occupational exposures affect later in life cognitive functioning or dementia occurrence. Higher occupational status, complex occupational roles, or jobs that are challenging seem to have a protective effect on cognitive functioning and dementia occurrence, even when controlling for education. Conversely, high-strain work and passive jobs that lack both self-direction and complexity are associated with cognitive impairment after retirement.
More specifically, regarding exposures, most studies have focused on the place of occupational toxicant exposures, mostly chemicals suspected to have long-term neurotoxic effects. Studies show a deleterious effect of chronic occupational exposures to solvents during active life. They also evidence that these effects on cognitive functioning remain important even after retirement, particularly for subjects with low education or high level of exposures. This has implications for physicians working with formerly solvent-exposed patients as well as for policies limiting exposure in the workplace.
To what extent occupational exposures contribute to social health inequalities in older age, taking into account the influence of non-occupational factors associated with socioeconomic position (measured by education, income, or household wealth), remains to be explored.
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