Occupational Determinants of Cognitive Decline and Dementia

  • Claudine BerrEmail author
  • Noémie Letellier
Living reference work entry
Part of the Handbook Series in Occupational Health Sciences book series (HDBSOHS, volume 1)


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.


Dementia Cognition Solvent Job strain Lifespan exposures Retirement Long-term effect 


  1. Adam S, Bonsang E, Grotz C, Perelman S (2013) Occupational activity and cognitive reserve: implications in terms of prevention of cognitive aging and Alzheimer’s disease. Clin Interv Aging 8:377–390. Scholar
  2. Alvarado BE, Zunzunegui MV, Del Ser T, Beland F (2002) Cognitive decline is related to education and occupation in a Spanish elderly cohort. Aging Clin Exp Res 14:132–142CrossRefGoogle Scholar
  3. Amieva H et al (2008) Prodromal Alzheimer’s disease: successive emergence of the clinical symptoms. Ann Neurol 64:492–498. Scholar
  4. Berr C, Vercambre MN, Bonenfant S, Manoux AS, Zins M, Goldberg M (2010) Occupational exposure to solvents and cognitive performance in the GAZEL cohort: preliminary results. Dement Geriatr Cogn Disord 30:12–19. Scholar
  5. Berr C, Balard F, Blain H, Robine JM (2012) How to define old age: successful aging and/or longevity. Med Sci (Paris) 28:281–287. Scholar
  6. Boffetta P, Jourenkova N, Gustavsson P (1997) Cancer risk from occupational and environmental exposure to polycyclic aromatic hydrocarbons. Cancer Causes Control 8:444–472CrossRefGoogle Scholar
  7. Bonsang E, Adam S, Perelman S (2012) Does retirement affect cognitive functioning? J Health Econ 31(3):490–501. Scholar
  8. Britton A, Shipley M, Singh-Manoux A, Marmot MG (2008) Successful aging: the contribution of early-life and midlife risk factors. J Am Geriatr Soc 56:1098–1105. Scholar
  9. Daniell WE, Claypoole KH, Checkoway H, Smith-Weller T, Dager SR, Townes BD, Rosenstock L (1999) Neuropsychological function in retired workers with previous long-term occupational exposure to solvents. Occup Environ Med 56:93CrossRefGoogle Scholar
  10. Daviglus ML et al (2011) Risk factors and preventive interventions for Alzheimer disease: state of the science. Arch Neurol 68:1185–1190. Scholar
  11. Fratiglioni L, Paillard-Borg S, Winblad B (2004) An active and socially integrated lifestyle in late life might protect against dementia. Lancet Neurol 3:343–353. Scholar
  12. Gamble JF (2000) Low-level hydrocarbon solvent exposure and neurobehavioural effects. Occup Med (Lond) 50:81–102CrossRefGoogle Scholar
  13. Genuis SJ, Kelln KL (2015) Toxicant exposure and bioaccumulation: a common and potentially reversible cause of cognitive dysfunction and dementia. Behav Neurol 2015:1. Scholar
  14. Goldberg M, Leclerc A, Bonenfant S, Chastang JF, Schmaus A, Kaniewski N, Zins M (2007) Cohort profile: the GAZEL Cohort Study. Int J Epidemiol 36:32–39. Scholar
  15. Hakansson N, Gustavsson P, Johansen C, Floderus B (2003) Neurodegenerative diseases in welders and other workers exposed to high levels of magnetic fields. Epidemiology 14:420–426; discussion 427–428. Scholar
  16. Harvard Report on Cancer Prevention (1996) Volume 1: causes of human cancer. Cancer Causes Control 7(Suppl 1):S3–S59Google Scholar
  17. Helmer C et al (2001) Occupation during life and risk of dementia in French elderly community residents. J Neurol Neurosurg Psychiatry 71:303–309CrossRefGoogle Scholar
  18. Imbernon E et al (1991) Matex: une matrice emplois-expositions destin‚ e … la surveillance‚ pid‚ miologique des travailleurs d’une grande entreprise (EDF-GDF). Arch Malprof 52:559Google Scholar
  19. Jack CR Jr et al (2013) Tracking pathophysiological processes in Alzheimer’s disease: an updated hypothetical model of dynamic biomarkers. Lancet Neurol 12:207–216. Scholar
  20. Karasek RA (1979) Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q 24:285CrossRefGoogle Scholar
  21. Karasek RA, Theorell T (1990) Healthy work. Stress, productivity and the reconstruction of working life. Basic Book, New YorkGoogle Scholar
  22. Karp A, Kareholt I, Qiu C, Bellander T, Winblad B, Fratiglioni L (2004) Relation of education and occupation-based socioeconomic status to incident Alzheimer’s disease. Am J Epidemiol 159:175–183CrossRefGoogle Scholar
  23. Kivimaki M, Leino-Arjas P, Luukkonen R, Riihimaki H, Vahtera J, Kirjonen J (2002) Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees. BMJ 325:857CrossRefGoogle Scholar
  24. Livingston G et al (2017) Dementia prevention, intervention, and care. Lancet 390:2673. Scholar
  25. Marquie JC, Tucker P, Folkard S, Gentil C, Ansiau D (2015) Chronic effects of shift work on cognition: findings from the VISAT longitudinal study. Occup Environ Med 72:258–264. Scholar
  26. Meng X, D’Arcy C (2012) Education and dementia in the context of the cognitive reserve hypothesis: a systematic review with meta-analyses and qualitative analyses. PLoS One 7:e38268. PONE-D-12-04086 [pii]CrossRefPubMedPubMedCentralGoogle Scholar
  27. Meng A, Nexo MA, Borg V (2017) The impact of retirement on age related cognitive decline - a systematic review. BMC Geriatr 17(1):160.
  28. Mikkelsen S (1997) Epidemiological update on solvent neurotoxicity. Environ Res 73:101–112CrossRefGoogle Scholar
  29. Moisan F et al (2015) Association of Parkinson’s disease and its subtypes with agricultural pesticide exposures in men: a case-control study in France. Environ Health Perspect 123:1123–1129. Scholar
  30. Mura T, Dartigues JF, Berr C (2010) How many dementia cases in France and Europe? Alternative projections and scenarios 2010–2050. Eur J Neurol 17:252–259. ENE2783 [pii]CrossRefPubMedGoogle Scholar
  31. Plassman BL, Williams JW Jr, Burke JR, Holsinger T, Benjamin S (2010) Systematic review: factors associated with risk for and possible prevention of cognitive decline in later life. Ann Intern Med 153:182–193. Scholar
  32. Potter GG, Plassman BL, Helms MJ, Foster SM, Edwards NW (2006) Occupational characteristics and cognitive performance among elderly male twins. Neurology 67:1377–1382. Scholar
  33. Potter GG, Helms MJ, Plassman BL (2008) Associations of job demands and intelligence with cognitive performance among men in late life. Neurology 70:1803–1808. Scholar
  34. Qiu C, Karp A, von Strauss E, Winblad B, Fratiglioni L, Bellander T (2003) Lifetime principal occupation and risk of Alzheimer’s disease in the Kungsholmen project. Am J Ind Med 43:204–211. Scholar
  35. Richards M, Deary IJ (2005) A life course approach to cognitive reserve: a model for cognitive aging and development? Ann Neurol 58:617–622. Scholar
  36. Sabbath EL, Glymour MM, Berr C, Singh-Manoux A, Zins M, Goldberg M, Berkman LF (2012) Occupational solvent exposure and cognition: does the association vary by level of education? Neurology 78:1754–1760. Scholar
  37. Sabbath EL et al (2014) Time may not fully attenuate solvent-associated cognitive deficits in highly exposed workers. Neurology 82:1716–1723. Scholar
  38. Sabbath EL, Andel R, Zins M, Goldberg M, Berr C (2016) Domains of cognitive function in early old age: which ones are predicted by pre-retirement psychosocial work characteristics? Occup Environ Med 73:640–647. Scholar
  39. Siegrist J, Marmot M (2004) Health inequalities and the psychosocial environment-two scientific challenges. Soc Sci Med 58:1463–1473. Scholar
  40. Siemiatycki J et al (2004) Listing occupational carcinogens. Environ Health Perspect 112:1447–1459. Scholar
  41. Singh-Manoux A, Marmot MG, Glymour M, Sabia S, Kivimaki M, Dugravot A (2011) Does cognitive reserve shape cognitive decline? Ann Neurol 70:296–304. Scholar
  42. Smyth KA, Fritsch T, Cook TB, McClendon MJ, Santillan CE, Friedland RP (2004) Worker functions and traits associated with occupations and the development of AD. Neurology 63:498–503CrossRefGoogle Scholar
  43. Stern Y (2002) What is cognitive reserve? Theory and research application of the reserve concept. J Int Neuropsychol Soc 8:448–460CrossRefGoogle Scholar
  44. Stern Y (2006) Cognitive reserve and Alzheimer disease. Alzheimer Dis Assoc Disord 20:S69–S74. 00002093-200607001-00010 [pii]CrossRefGoogle Scholar
  45. Then FS et al (2014) Systematic review of the effect of the psychosocial working environment on cognition and dementia. Occup Environ Med 71:358–365CrossRefGoogle Scholar
  46. Valenzuela MJ, Sachdev P (2006) Brain reserve and dementia: a systematic review. Psychol Med 36:441–454. Scholar
  47. van Valen E, Wekking E, van der Laan G, Sprangers M, van Dijk F (2009) The course of chronic solvent induced encephalopathy: a systematic review. Neurotoxicology 30:1172–1186. Scholar
  48. Virtanen M et al (2009) Long working hours and cognitive function: the Whitehall II Study. Am J Epidemiol 169:596–605. Scholar
  49. Wang HX, Wahlberg M, Karp A, Winblad B, Fratiglioni L (2012) Psychosocial stress at work is associated with increased dementia risk in late life. Alzheimers Dement 8:114–120. Scholar
  50. Wang HX, MacDonald SW, Dekhtyar S, Fratiglioni L (2017) Association of lifelong exposure to cognitive reserve-enhancing factors with dementia risk: a community-based cohort study. PLoS Med 14:e1002251. Scholar
  51. White RF, Proctor SP (1997) Solvents and neurotoxicity. Lancet 349:1239–1243CrossRefGoogle Scholar
  52. Yu F, Ryan LH, Schaie KW, Willis SL, Kolanowski A (2009) Factors associated with cognition in adults: the Seattle Longitudinal Study. Res Nurs Health 32:540–550. Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Neuropsychiatry: Epidemiological and Clinical ResearchINSERM U1061, University of MontpellierMontpellierFrance
  2. 2.Centre Mémoire Ressources et RechercheHôpital Gui de ChauliacMontpellierFrance

Personalised recommendations