职业因素与痴呆或认知障碍的关联：系统评价和荟萃分析。

Association of Occupational Factors and Dementia or Cognitive Impairment: A Systematic Review and Meta-Analysis.

机构信息

Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China.

Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China.

出版信息

J Alzheimers Dis. 2020;78(1):217-227. doi: 10.3233/JAD-200605.

DOI:10.3233/JAD-200605

PMID:32986670

Abstract

BACKGROUND

Several existing studies have reported that occupational factors might play an important part in cognitive function with aging.

OBJECTIVE

We aim to explore the associations between modifiable occupational factors and risk of dementia or mild cognitive impairment (MCI).

METHODS

Adopting random-effect models, this study conducted primary analyses for all occupational factors and subgroup analyses for the effect of occupation type based on prospective cohort and case-control studies searched from PubMed and EMBASE databases up to March 2020.

RESULTS

Among the 38,111 identified literatures, 9 studies on occupation type, 4 studies on work complexity, and 30 studies on occupational exposure were included. In terms of occupation type, mental work conferred a 44% reduced risk (95% CI = 0.34-0.94, I² = 85.00%, p < 0.01) for MCI. In terms of work complexity, higher work complexity conferred a 5% reduced risk (95% CI = 0.91-1.00, I² = 57.00%, p < 0.01) for dementia. In terms of occupational exposure, high strain and passive job in the longest-held job conferred a 1.21- and 1.15-fold excess risk (95% CI = 1.05-1.39 I² = 62.00%, p < 0.05; 95% CI = 1.05-1.26 I² = 31.00%, p = 0.23; respectively) of cognitive decline. Besides, magnetic field exposure conferred a 1.26-fold excess risk (95% CI = 1.01-1.57, I² = 69.00%, p < 0.01) for dementia.

CONCLUSION

Novel prevention strategies based on occupational factors may hold promise against dementia and MCI.

摘要

背景

一些现有的研究报告称，职业因素可能在认知功能随年龄增长方面起着重要作用。

目的

我们旨在探索可改变的职业因素与痴呆或轻度认知障碍（MCI）风险之间的关系。

方法

采用随机效应模型，本研究对所有职业因素进行了主要分析，并根据前瞻性队列研究和病例对照研究，对基于职业类型的亚组分析进行了探索，这些研究结果来自于 PubMed 和 EMBASE 数据库，搜索时间截至 2020 年 3 月。

结果

在 38111 篇鉴定文献中，纳入了 9 项关于职业类型、4 项关于工作复杂性和 30 项关于职业暴露的研究。就职业类型而言，脑力工作可降低 44%的 MCI 风险（95%CI=0.34-0.94，I²=85.00%，p<0.01）。就工作复杂性而言，较高的工作复杂性可降低 5%的痴呆风险（95%CI=0.91-1.00，I²=57.00%，p<0.01）。就职业暴露而言，最长时间从事的高强度工作和被动工作赋予了 1.21 倍和 1.15 倍的认知下降超额风险（95%CI=1.05-1.39，I²=62.00%，p<0.05；95%CI=1.05-1.26，I²=31.00%，p=0.23）。此外，磁场暴露与痴呆的 1.26 倍超额风险相关（95%CI=1.01-1.57，I²=69.00%，p<0.01）。