Integrating Health Equity and Productive Aging Perspectives to Improve Cognitive Health

Background and Purpose: An increasing number of older adults are working, and they are spending a great amount of time in the workplace. Studies indicate that appropriate work tasks and cognitive stimulation can contribute to healthy cognitive aging. A range of job characteristics predicts older adults’ health. However, less is known about how subjective work demands (i.e., overall work, physical, mental, and interpersonal demands) predict episodic memory function, which is a valid indicator of cognition in old age. Although previous literature has demonstrated the positive impact of cognitively stimulating work on cognition, relatively little research exists exploring inequities by race, particularly as they relate to: occupation type; self-perceived ability to work; self-rated ability to meet physical, mental, and interpersonal demands of work; and episodic memory. Guided by health equity and productive aging perspectives, this study investigates these associations among older Whites and Blacks in the United States.

Methods: Using nationally representative panel data from the Health and Retirement Study (2010 and 2012 waves) in the United States, lagged dependent variable models were performed among Leave-Behind Questionnaire (LBQ) respondents aged 51+ who were engaged in the labor force (N=2,163). We analyzed work demands in each of four areas: overall work demands, physical work demands, mental work demands, and interpersonal demands. Occupation type was categorized into three groups: professional/managerial occupations, clerical/sales/service occupations, and blue-collar occupations. Models were stratified by race.

Results: Both White and Black older adults working in blue-collar occupations had worse episodic memory when compared to those in professional/managerial occupations. Among Blacks, engaging in clerical/sales/service occupations was associated with worse episodic memory compared to engaging in professional/managerial occupations. For both White and Black older adults, higher perceived ability to meet mental demands was associated with higher levels of episodic memory. Interpersonal demands and cognition were significantly associated among Blacks, but were trending towards positive associations among Whites.

Conclusions and Implications: Promoting cognitively and socially stimulating work environments is essential to health equity. Moreover, providing support and resources for older adults who are engaged in blue-collar occupations or clerical/sales/service occupations is important. Race differences imply the greater need to provide age-friendly workplaces for older workers of color. This can be done by providing appropriate work demands and additional support to meet these demands. It is recommended that future research take into account both objective and self-perceived work complexity to deepen the understanding of the workplace-cognition relationship. Social work policy, practice, and research implications of these findings are discussed.