title: Midlife Work-Related Stress Increases Dementia Risk in Later Life: The CAIDE 30-Year Study.
abstract: OBJECTIVE
  To investigate the associations between midlife work-related stress and mild cognitive impairment (MCI), dementia, and Alzheimer's disease later in life, in a large representative population.
  
  
  METHODS
  Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study participants were randomly selected from independent population-based surveys (mean age 50 years). A random sample of 2,000 individuals was invited for two reexaminations including cognitive tests (at mean age 71 and mean age 78), and 1,511 subjects participated in at least one reexamination (mean follow-up 28.5 years). Work-related stress was measured using two questions on work demands that were administered in midlife. Analyses adjusted for important confounders.
  
  
  RESULTS
  Higher levels of midlife work-related stress were associated with higher risk of MCI (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.08-1.76), dementia (OR, 1.53; CI, 1.13-2.07), and Alzheimer's disease (OR, 1.55; CI, 1.19-2.36) at the first follow-up among the CAIDE participants. Results remained significant after adjusting for several possible confounders. Work-related stress was not associated with MCI and dementia during the extended follow-up.
  
  
  CONCLUSIONS
  Midlife work-related stress increases the risk for MCI, dementia, and Alzheimer's disease in later life. The association was not seen after the extended follow-up possibly reflecting selective survival/participation, heterogeneity in dementia among the oldest old, and a critical time window for the effects of midlife stress.
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.
authors.forename: Shireen
authors.initials: S
authors.lastname: Sindi
authors.affiliation: Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.
authors.forename: Göran
authors.initials: G
authors.lastname: Hagman
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.
authors.forename: Krister
authors.initials: K
authors.lastname: Håkansson
authors.affiliation: Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Jenni
authors.initials: J
authors.lastname: Kulmala
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.
authors.forename: Charlotta
authors.initials: C
authors.lastname: Nilsen
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.|Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
authors.forename: Ingemar
authors.initials: I
authors.lastname: Kåreholt
authors.affiliation: NeuroCenter, Department of Neurology, Kuopio University Hospital, Kuopio, Finland.|Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.|Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Alina
authors.initials: A
authors.lastname: Solomon
authors.affiliation: Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.|Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.|Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.|Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Miia
authors.initials: M
authors.lastname: Kivipelto
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000209:etiology* / Q000523:psychology*; D060825:Cognitive Dysfunction / Q000209:etiology* / Q000523:psychology; D003704:Dementia / Q000209:etiology* / Q000523:psychology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011594:Psychometrics; D012306:Risk; D013223:Statistics as Topic; D013315:Stress, Psychological / Q000150:complications* / Q000523:psychology*; D013548:Sweden; D016526:Workload / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Alzheimer’s disease—Dementia—Job demands—Midlife risk
                      factors—Mild cognitive impairment—Stress—Work-related stress