title: Motivational reserve: motivation-related occupational abilities and risk of mild cognitive impairment and Alzheimer disease.
abstract: Midlife motivational abilities, that is, skills to initiate and persevere in the implementation of goals, have been related to mental and physical health, but their association with risk of mild cognitive impairment (MCI) and Alzheimer's disease (AD) has not yet been directly investigated. This relation was examined with data from the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). A total of 3,327 nondemented participants (50.3% of a randomly selected sample) aged 75-89 years were recruited in primary care and followed up twice (after 1.5 and 3 years). Motivation-related occupational abilities were estimated on the basis of the main occupation (assessed at follow-up II) using the Occupational Information Network (O* NET) database, which provides detailed information on worker characteristics and abilities. Cox proportional hazards models were used to evaluate the relative risk of developing MCI and AD in relation to motivation-related occupational abilities, adjusting for various covariates. Over the 3 years of follow-up, 15.2% participants developed MCI and 3.0% developed AD. In a fully adjusted model, motivation-related occupational abilities were found to be associated with a reduced risk of MCI (HR: 0.77; 95% CI: 0.64-0.92). Motivation-related occupational abilities were associated with reduced risk of AD in ApoE ε4 carriers (HR: 0.48; CI: 0.25-0.91), but not in noncarriers (HR: 0.99; CI: 0.65-1.53). These results suggest that midlife motivational abilities are associated with reduced risk of MCI in general and with reduced risk of AD in ApoE ε4 carriers. Revealing the mechanisms underlying this association may inform novel prevention strategies for decelerating cognitive decline in old age.
authors.affiliation: Department of Psychopathologyand Clinical Intervention, University of Zurich, Zurich, Switzerland. s.forstmeier@psychologie.uzh.ch
authors.forename: Simon
authors.initials: S
authors.lastname: Forstmeier
authors.forename: Andreas
authors.initials: A
authors.lastname: Maercker
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Hendrik
authors.initials: H
authors.lastname: van den Bussche
authors.forename: Steffi
authors.initials: S
authors.lastname: Riedel-Heller
authors.forename: Hanna
authors.initials: H
authors.lastname: Kaduszkiewicz
authors.forename: Michael
authors.initials: M
authors.lastname: Pentzek
authors.forename: Siegfried
authors.initials: S
authors.lastname: Weyerer
authors.forename: Horst
authors.initials: H
authors.lastname: Bickel
authors.forename: Franziska
authors.initials: F
authors.lastname: Tebarth
authors.forename: Melanie
authors.initials: M
authors.lastname: Luppa
authors.forename: Anja
authors.initials: A
authors.lastname: Wollny
authors.forename: Birgitt
authors.initials: B
authors.lastname: Wiese
authors.forename: Michael
authors.initials: M
authors.lastname: Wagner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000523:psychology*; D000544:Alzheimer Disease / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology; D053327:Apolipoprotein E4; D060825:Cognitive Dysfunction / Q000453:epidemiology* / Q000523:psychology; D058245:Cognitive Reserve / Q000502:physiology*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D005858:Germany / Q000453:epidemiology; D006040:Goals; D006579:Heterozygote; D006801:Humans; D015994:Incidence; D007406:Interview, Psychological; D008297:Male; D009042:Motivation / Q000502:physiology*; D009483:Neuropsychological Tests; D009790:Occupations; D011361:Professional Competence; D016016:Proportional Hazards Models; D012307:Risk Factors; D020377:Self Efficacy
chemical_list: D053327:Apolipoprotein E4