Impact of Employment Status on Subjective Cognitive Decline Among Georgians 45 and Older

Abstract

Background

Subjective cognitive decline (SCD) is a self-reported experience of worsening or more frequent confusion or memory loss that is associated with future risk of Alzheimer’s. Unemployment contributes to developing SCD. However, the risk of SCD in the unemployed older population may vary. We investigate the risk of SCD by employment status among adults in Georgia.

Methods

Data from the 2013, 2015, 2017, 2019, and 2021 Georgia Behavioral Risk Factor Surveillance System were combined. Respondents aged 45 and older experiencing SCD in the past 12 months were identified. Respondents were either employed (employed for wages, self-employed, or out of work less than a year), retired, or unemployed (out of work for more than a year). Logistic regression was performed with SCD as outcome and employment status as predictor. Sex, age, race/ethnicity, education, and income were covariates.

Results

Overall prevalence of SCD was 12.1%. SCD was higher among those with less than high school education (20.4%), and annual income less than $15,000 (22.9%). SCD prevalence was highest among those unemployed (Adjusted Prevalence Ratio: 2.2, 95% CI: 1.6, 3.0) than retired (APR: 1.6, 95% CI: 1.3, 2.0) compared to those employed. SCD prevalence remained the same when stratified by age, unemployed 45-64 (APR: 1.9, 95% CI: 1.4, 2.8); retired 45-64 (APR: 1.6, 95% CI: 1.2, 2.0); unemployed 65+ (APR: 2.3, 95% CI: 1.1, 4.9); retired 65+ (APR: 1.8, 95% CI: 1.3, 2.4).

Conclusion

Experiencing SCD is significantly higher among retired and unemployed persons compared to those who are employed. However, the risk of SCD was greater among the unemployed than retired. This reveals that more than the mere absence of employment the reason for unemployment is critical in SCD development. To be effective, programs to prevent SCD among unemployed older adults in Georgia must consider the reason for unemployment.

Keywords

Subjective cognitive decline, healthy aging, unemployed, retired.

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Impact of Employment Status on Subjective Cognitive Decline Among Georgians 45 and Older

Background

Subjective cognitive decline (SCD) is a self-reported experience of worsening or more frequent confusion or memory loss that is associated with future risk of Alzheimer’s. Unemployment contributes to developing SCD. However, the risk of SCD in the unemployed older population may vary. We investigate the risk of SCD by employment status among adults in Georgia.

Methods

Data from the 2013, 2015, 2017, 2019, and 2021 Georgia Behavioral Risk Factor Surveillance System were combined. Respondents aged 45 and older experiencing SCD in the past 12 months were identified. Respondents were either employed (employed for wages, self-employed, or out of work less than a year), retired, or unemployed (out of work for more than a year). Logistic regression was performed with SCD as outcome and employment status as predictor. Sex, age, race/ethnicity, education, and income were covariates.

Results

Overall prevalence of SCD was 12.1%. SCD was higher among those with less than high school education (20.4%), and annual income less than $15,000 (22.9%). SCD prevalence was highest among those unemployed (Adjusted Prevalence Ratio: 2.2, 95% CI: 1.6, 3.0) than retired (APR: 1.6, 95% CI: 1.3, 2.0) compared to those employed. SCD prevalence remained the same when stratified by age, unemployed 45-64 (APR: 1.9, 95% CI: 1.4, 2.8); retired 45-64 (APR: 1.6, 95% CI: 1.2, 2.0); unemployed 65+ (APR: 2.3, 95% CI: 1.1, 4.9); retired 65+ (APR: 1.8, 95% CI: 1.3, 2.4).

Conclusion

Experiencing SCD is significantly higher among retired and unemployed persons compared to those who are employed. However, the risk of SCD was greater among the unemployed than retired. This reveals that more than the mere absence of employment the reason for unemployment is critical in SCD development. To be effective, programs to prevent SCD among unemployed older adults in Georgia must consider the reason for unemployment.