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SO085

Non-employment and cognitive health in later life in Taiwan: psychiatric epidemiological evidence from a four-wave longitudinal study

NOT WORKING AND LATE-LIFE COGNITIVE HEALTH IN TAIWAN: PSYCHIATRIC EPIDEMIOLOGY FROM FOUR LONGITUDINAL WAVES STUDY

Non-employment was associated with higher odds of cognitive impairment across all waves; in prospective analyses, employment significantly predicted only subsequent episodic memory.

The study aimed to examine the relationship between employment status and cognitive outcomes using longitudinal data from Taiwan. Four waves of the Taiwan Longitudinal Study on Aging (1996, 1999, 2003, 2007) were analyzed; 5,131 participants were included at baseline, and 2,756 completed all waves. Exposure was classified at each wave as employed or not employed (including unemployment and retirement); cognitive outcomes were measured as cognitive impairment (SPMSQ score of 3 or higher), episodic memory (10-item free recall), and working memory (digit span). The analyses used logistic regression adjusted for age, sex, education, chronic diseases, and functional status (aOR), and generalized estimating equations (GEE) for repeated measures. Non-employment was associated with higher odds of cognitive impairment across all waves: aOR 2.73 (1.19 to 6.31; p < 0.05) in 1996, 4.15 (2.01 to 8.57; p < 0.001) in 1999, 2.52 (1.43 to 4.42; p < 0.01) in 2003, and 2.19 (1.13 to 4.26; p < 0.05) in 2007; the aOR for an incorrect response on the backward digit span task was 1.19 (1.01 to 1.40; p < 0.05) in 1996 and 1.48 (1.12 to 1.97; p < 0.01) in 2007, but was not significant in the 1999 and 2003 waves. In the repeated-measures GEE models, the effect of employment status was not significant for cognitive impairment, with beta = 0.854 (0.592 to 1.234; p = 0.401), or backward digit span, with beta = 0.952 (0.901 to 1.007; p = 0.084), but was significant for 10-item free recall, with beta = 0.215 (0.007 to 0.423; p = 0.043). The authors note that employment in later life is associated with subsequent episodic memory, that the cross-sectional association between non-employment and cognitive impairment may partly reflect health selection, and that sustained participation in work may support cognitive resilience.

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