Mentally Challenging Occupations Are Associated with More Rapid Cognitive Decline at Later Stages of Cognitive Aging

Objectives: Engaging in mentally challenging activities is associated with reduced risk for cognitive impairment and dementia; however, its association with rates of cognitive decline has been inconsistent. The aim of this study is to test whether working in mentally challenging occupations is related to rates of cognitive change at later older adulthood. Method: The sample consisted of 1,520 individuals (baseline mean age = 78.6 ± 5.1, range = 64-100) from the Einstein Aging Study. Occupation information of each participant was collected retrospectively and linked with the substantive complexity of work score from the Dictionary of Occupational Titles. Cognitive changes in memory, speed, and executive function (EF) domains were represented using two time metrics (i.e., time from retirement, time from study enrollment). Results: Results from mixed models showed that occupational complexity was associated with significantly faster rates of cognitive decline in speed and EF in the "time from retirement"model but not in the "time from baseline"model. Despite faster cognitive loss, the protective effect of occupational complexity persisted for decades after retirement due to higher initial levels of cognition. Discussion: The result suggests that protective factors for cognitive health may be associated with delayed onset but more rapid cognitive decline afterwards at later stages of cognitive aging.