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As the number of older adults with dementia increases as the US population ages, researchers are working to understand what factors may contribute to cognitive health late in life throughout life. A new study from Kaiser Permanente Research section Investigators suggest that one factor may be how intellectually challenging a person’s job is.

Yenee Soh
Yeni Suh, Scd, Sm

The search was led Yeni SuhScD, DOR Research Fellow, and DOR Investigator Paula Gilsanz, SCD. the the findings They are published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association.

The authors discuss their findings and what comes next.

What do we know so far about using our brains to keep them healthy?

suh: Plenty of research indicates that intellectually stimulating activities throughout adulthood are associated with better cognitive outcomes, and complex work environments have been examined as a source of such intellectually stimulating activities. Several studies have shown that more professional complexity provided by one’s occupation is associated with better cognition in later life. Very few have looked at these associations in a racially and ethnically diverse population.

How has Kaiser Permanente’s data given you unique insight into this topic?

Gilsanz Paola 0028 Lores
Paula Gilsanz, Skd

Gilsanz: We used data from the Kaiser Healthy Aging and Diverse Life Experiences Study, also known as KHANDLE. The participants are a diverse group of long-term members of Kaiser Permanente Northern California who are ages 65 and older. To be eligible, Kaiser members had to have participated in at least one voluntary examination between 1964 and 1985 which included a health questionnaire and clinical measures. This is really exciting because we are able to look at data from early in their lives along with the information they provided about life experience and health indicators during the KHANDLE interviews.

How do you measure occupational complexity?

suh: KHANDLE participants provided information about their major lifetime occupations, and using federal job classifications, each participant’s job was linked to three dimensions of work complexity: complexity with data, complexity with people, and complexity with things. We then examined how each occupational complexity score was associated with three domains of cognition: executive function, semantic memory, and verbal episodic memory.

what did you learn?

suh: We found that higher occupational complexity with data was associated with higher baseline executive function and semantic memory, as well as a slower decline in executive function. We also found that higher occupational complexity with people was associated with higher baseline cognition across the board. We did not find that the links between occupational complexity and cognition differed by race.

But we did find differences in levels of occupational complexity in jobs reported by race and ethnicity, reflecting how structural racism affects job opportunities and opportunities for cognitive stimulation of work environments.

So does this study mean that young people should take intellectually challenging jobs to avoid dementia?

suh: These results indicate that more intellectually challenging jobs are associated with cognitive benefits. However, we still do not know the pathways behind how occupational complexity affects cognitive abilities. More research will help translate these findings into workplace interventions or career decisions for cognitive health.

What should be studied next in this topic?

suh: There are many work characteristics and environmental factors that must be taken into account to better understand the relationship between occupation and knowledge. This may include occupational standing, job hazards, or job stress. Future research should consider how these factors, in association, relate to the risk of cognitive outcomes late in life.

Gilsanz: Understanding the mechanisms through which occupations and jobs influence healthy brain aging is really important, especially if we identify the things we can change. This way you can intervene and hopefully improve healthy brain aging for everyone.

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About Kaiser Permanente’s Department of Research

The Research Division of Kaiser Permanente conducts, reports, and disseminates health and epidemiological services research to improve medical and health care for Kaiser Permanente members and the community at large. It seeks to understand the determinants of disease and well-being, and to improve the quality and cost-effectiveness of health care. Currently, more than 600 DOR employees are working on more than 450 research projects in the field of epidemiology and health services. For more information visit Or follow us on @KPDOR.