PROLONGING HEALTHY WORKING LIVES: THE ASSOCIATION OF JOB CHARACTERISTICS AND WORKFORCE EXIT WITH MENTAL AND COGNITIVE HEALTH IN MID- AND LATE LIFE
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Objectives: Because work and health interacts with each other over the life course, job characteristics and health factors associated with labor force participation deserve great research attention to reduce disease burden and protect human capital. This dissertation aimed to examine the association between psychosocial job characteristics and cognitive decline (Chapter 2 and 3) and the association between insomnia symptoms and job exit (Chapter 4) among middle-aged and older adults. Methods: In Chapter 2, the association between cumulative work activities and cognitive changes was examined by multiple linear regression, using data from the Baltimore Epidemiologic Catchment Area (ECA) follow-up study and the Occupational Information Network. The interaction between workplace social interaction and physical demands was tested. In Chapter 3, the association between job strain at midlife and changes in cognitive function later in life was examined in a sample from the Baltimore ECA study using multiple linear regression models. In Chapter 4, the association between insomnia symptoms and subsequent job exit was examined in a nationally representative sample from the Health and Retirement Study using multinomial logistic regression models. Results: In Chapter 2, higher cumulative mental demands or social interaction were significantly associated with less decrease in cognitive function as assessed by the Mini-Mental State Examination (MMSE) and the Immediate and Delayed Word Recall tasks. Higher cumulative physical demands were associated with greater decline in the MMSE, and the association was moderated by social interaction. In Chapter 3, participants with high strain jobs had significantly greater cognitive decline as assessed by the MMSE and Immediate Word Recall task, compared to those with low strain jobs. Analyses of Chapter 4 found that having more insomnia symptoms was associated with increased odds of health-related job exit. There was no association between insomnia and job exit due to non-health reasons. Conclusions: The studies demonstrated potential intervention points in the workplace for promoting cognitive health later in life, and indicated the potential economic burden of insomnia that was attributable to reducing people’s working lives. Future research should investigate the role of workplace social support in improving the psychosocial work environment and prolonging workforce participation.