Retirement and Dementia

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On Monday, July 15, at 4:00 PM at the Alzheimer’s Association International Conference in Boston, Carole Dufouil, director of research in neuroepidemiology at the Institut National de la santé et de la recherché médicale at the Bordeaux School of Public Health in France, presented her research on the relationship between retirement and dementia. In less than 24 hours her report on the research, which has not yet been published, was all over the media and the blogosphere.

Dufouil and her colleagues linked health and pension databases for 430,000 French workers who were living and retired as of 2010. The workers had been retired for an average of 12 years. Their average age was 74. Dufouil told the Associated Press that for each additional year of work, the risk of dementia decreased by 3.2%.

The researchers were able to control for factors like gender, marital status, occupational category, hypertension, and diabetes. But the obvious concern about a correlational study like this is that individuals in the earliest phases of dementia would be more likely to retire. In that case, retirement would be the result of dementia, not a cause. To control for dementia as the cause of retirement, Dufouil did analyses that eliminated all those who developed dementia five and ten years after retirement. But the finding still held, which added persuasiveness to the “use it or lose it” hypothesis about mental functioning.

Unlike the media stories, which suggested that if we work until we drop we’ll be able to prevent dementia, Defouil’s conclusion was appropriately cautious: “[Work] may be an important determinant of intellectual stimulation and mental engagement, which are thought to be potentially protective against dementia. As countries around the world respond to the aging of their populations, our results highlight the importance of maintaining high levels of cognitive and social stimulation throughout work and retired life, and they emphasize the need for policies to help older individuals achieve cognitive and social engagement.”

We know that employment status has profound implications for health. In a post, “Job Loss and Mortality,” I reported that job loss during a recession in the U.S. was correlated with reduced longevity. And Carol Levine posted about the personal importance working into our 70s (and beyond) can assume. Whether or not the findings reported by Dr. Dufouil hold up over time, they’re consistent with all that we know about the importance of work. Freud taught that work and love were the primary determinants of psychological health. Research like that done by Dr. Dufouil and her colleagues suggests that work and love are crucial for “physical health” as well!

James Sabin, M.D., 74, is an organizer of Over 65 and a clinical professor of psychiatry at Harvard Medical School.

2 Responses to “Retirement and Dementia”

  1. Steve Moffic

    I saw that interesting study, too, but caution about “work” being preventive. Repetitive work may not be mentally stimulating or emotionally enjoyable at all. Here, if one has the financial opportunity to retire, learning new things should surely be more stimulating.
    As we somewhat desperately search for ways to reduce dementia, the conclusions can be simplistic and temporary until the next “findings” emerge.

  2. James Sabin

    Hi Steve –
    I agree that we are hungry for strategies to prevent dementia. And I agree that even if the “use it or lose it” hypothesis pans out over time, not all work involves stimulating our brains. I thought Dr. Defouil’s comments were sensible and fair, but there’s no doubt that some of the public will jump to a simplistic conclusion. But work and other forms of mental/social engagement that are positive for a person don’t have negative “side effects,” and for that reason I see her research and her interpretation of its implications as a constructive contribution.
    Best
    Jim