Why women who work are less likely to develop dementia

By Lois Zoppi, B.A.Jul 17 2019Reviewed by Kate Anderton, B.Sc. (Editor)

A new study has suggested that engaging in paid work may protect women against cognitive decline and reduce their risk of dementia. The research, although preliminary and not published in a peer-reviewed medical journal, was presented at the Alzheimer’s Association International Conference in Los Angeles earlier this week.

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According to statistics released by the US Department of Labor, women constitute almost 47 percent of the workforce. While this has clear benefits for women’s social and economic mobility, independence, and overall wellbeing, new research has suggested that women’s cognitive health in older age could also benefit from being employed in paid work throughout their lives.

The authors of the research believe that their work could enhance the importance of policies that help women stay in work, with “Policies that promote equal pay for equal work, paid family leave and affordable childcare” becoming part of the conversation about women’s dementia in old age according to the lead researcher and epidemiologist Elizabeth Rose Mayeda.

Mayeda and her research team studied over 6,000 women born between 1935 and 1956 and collected their family and employment history through the age of 50. From 1995 to 2016, the women had regular cognitive assessments during which they were asked to recall lists of words from memory and fill out questionnaires on cognitive decline.

Results showed that the rate of memory decline was similar in mothers and non-mothers who worked, but the cognitive decline was fastest in women who did not work.

Married mothers who did not work found their memory decline 61 percent faster over a decade when compared to married mothers who were employed in paid work.

Rates of cognitive decline were significantly higher in single mothers without paid work, whose memory declined 83 percent faster if they didn’t work.

Roles for women in the workforce and family have really changed dramatically over the years. So it’s important that we continue to study the relevance of those changes and how they could be impacting the risk for women related to Alzheimer’s disease.”

Rebecca Edelmayer, Director of Scientific Engagement, Alzheimer’s Association

Working keeps the brain active

With working, married mothers, working single mothers, stay-at-home married mothers, and stay-at-home single mothers included in the study, results showed that after the age of 60, cognitive decline was seen amongst most of the women, which is natural and, to some extent, expected.

However, it was found that women aged 70 who had worked outside of the home did as well on cognitive tests as 65-year-old women who did not work. It is important to note that none of the women studied were living with dementia in any of its stages. But this research does suggest that working could contribute to women’s cognitive resilience in older age.

Mayeda emphasized that women did not have to be in continuous paid work for the cognitive benefits to extend to later life, meaning women who took time out of the workforce to care for families, for example, still saw the benefits in later life.

“Women who engaged in the paid labor force for at least a significant time period appeared to have slower rates of memory decline in later age,” said Mayeda. “It didn’t mean that you had to work continuously, for example, in your 20s, 30s and 40s.”

Edelmayer described working in mid-life may be “protective” for women in regard to cognitive decline, and cognitive resilience could be enhanced by engaging in activities that require the brain to carry out complex tasks such as learning. Neurologists have, in the past, found that staying in education for longer could prevent dementia.

Similarly, highly skilled jobs that require a post-college degree can lead people to do better on cognitive tests in later life. This is particularly true if these jobs involve math.

Working provides added benefits that may protect cognitive function

Dr. John Rowe, a professor of health policy and aging at Columbia’s Mailman School of Public Health said that having paid work offers economic benefits that also influence health outcomes.

“They’re in the labor force which means they may have health insurance, which gives them better access to care than people without health insurance,” he said.

However, Rowe highlights that volunteering also has benefits to women’s health as they age, as social engagement through work also contributes to a lower risk of cognitive decline in older age, which is an element of both paid and unpaid work. Rowe explained:

“There are many studies that have shown that people who are engaged have greater physical and cognitive well-being that people who are not,” he said.

We need to begin to look at engagement, work for pay or volunteering, as health promotion and disease prevention. When a physician sees a patient, they shouldn’t just be asking about blood pressure and exercise but should also ask how patients spend their lives.”

Dr. John Rowe

“Our project is really looking at the social experience of women,” Mayeda said, but as almost two-thirds of Americans with dementia are women (3.5 million of 5.6 million women aged 65 and over) it is easy to see that research of this kind has particular importance in ensuring, or at least improving, the chances of lifelong cognitive health for women.

Socioeconomic changes can also help to keep women in the workforce and allow them to possibly benefit from better cognitive health in later life, such as better childcare policy, flexible working hours, and crucially, closing the gender pay gap.