Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve

Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenanc...

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Published in:	Frontiers in psychology Vol. 13; p. 957308
Main Authors:	Kleineidam, Luca, Wolfsgruber, Steffen, Weyrauch, Anne-Sophie, Zulka, Linn E., Forstmeier, Simon, Roeske, Sandra, van den Bussche, Hendrik, Kaduszkiewicz, Hanna, Wiese, Birgitt, Weyerer, Siegfried, Werle, Jochen, Fuchs, Angela, Pentzek, Michael, Brettschneider, Christian, König, Hans-Helmut, Weeg, Dagmar, Bickel, Horst, Luppa, Melanie, Rodriguez, Francisca S., Freiesleben, Silka Dawn, Erdogan, Selin, Unterfeld, Chantal, Peters, Oliver, Spruth, Eike J., Altenstein, Slawek, Lohse, Andrea, Priller, Josef, Fliessbach, Klaus, Kobeleva, Xenia, Schneider, Anja, Bartels, Claudia, Schott, Björn H., Wiltfang, Jens, Maier, Franziska, Glanz, Wenzel, Incesoy, Enise I., Butryn, Michaela, Düzel, Emrah, Buerger, Katharina, Janowitz, Daniel, Ewers, Michael, Rauchmann, Boris-Stephan, Perneczky, Robert, Kilimann, Ingo, Görß, Doreen, Teipel, Stefan, Laske, Christoph, Munk, Matthias H. J., Spottke, Annika, Roy, Nina, Brosseron, Frederic, Heneka, Michael T., Ramirez, Alfredo, Yakupov, Renat, Scherer, Martin, Maier, Wolfgang, Jessen, Frank, Riedel-Heller, Steffi G., Wagner, Michael
Format:	Journal Article
Language:	English
Published:	Switzerland Frontiers Media S.A 08.12.2022
Subjects:	Alzheimer's disease brain maintenance brain reserve cognitive reserve mid-life cognitive demands occupation Psychology Psykologi occupation mid-life cognitive demands Alzheimer's disease brain maintenance brain reserve cognitive reserve
ISSN:	1664-1078, 1664-1078
Online Access:	Get full text
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Abstract	Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.
AbstractList	Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the ONET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology. Introduction: Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them. Methods: We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the ONET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE). Results: Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM. Discussion: Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology. IntroductionSeveral lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them.MethodsWe systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the ONET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE).ResultsRegarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.DiscussionOur results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology. Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them.IntroductionSeveral lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been described for occupational cognitive requirements (OCR) in midlife, it is currently unknown whether they are conveyed by brain maintenance (BM), brain reserve (BR), or cognitive reserve (CR) or a combination of them.We systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the ONET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE).MethodsWe systematically derived hypotheses for these resilience concepts and tested them in the population-based AgeCoDe cohort and memory clinic-based AD high-risk DELCODE study. The OCR score (OCRS) was measured using job activities based on the O*NET occupational classification system. Four sets of analyses were conducted: (1) the interaction of OCR and APOE-ε4 with regard to cognitive decline (N = 2,369, AgeCoDe), (2) association with differentially shaped retrospective trajectories before the onset of dementia of the Alzheimer's type (DAT; N = 474, AgeCoDe), (3) cross-sectional interaction of the OCR and cerebrospinal fluid (CSF) AD biomarkers and brain structural measures regarding memory function (N = 873, DELCODE), and (4) cross-sectional and longitudinal association of OCR with CSF AD biomarkers and brain structural measures (N = 873, DELCODE).Regarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.ResultsRegarding (1), higher OCRS was associated with a reduced association of APOE-ε4 with cognitive decline (mean follow-up = 6.03 years), consistent with CR and BR. Regarding (2), high OCRS was associated with a later onset but subsequently stronger cognitive decline in individuals converting to DAT, consistent with CR. Regarding (3), higher OCRS was associated with a weaker association of the CSF Aβ42/40 ratio and hippocampal volume with memory function, consistent with CR. Regarding (4), OCR was not associated with the levels or changes in CSF AD biomarkers (mean follow-up = 2.61 years). We found a cross-sectional, age-independent association of OCRS with some MRI markers, but no association with 1-year-change. OCR was not associated with the intracranial volume. These results are not completely consistent with those of BR or BM.Our results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.DiscussionOur results support the link between OCR and CR. Promoting and seeking complex and stimulating work conditions in midlife could therefore contribute to increased resistance to pathologies in old age and might complement prevention measures aimed at reducing pathology.
Author	Peters, Oliver Spottke, Annika Freiesleben, Silka Dawn Weeg, Dagmar Butryn, Michaela Priller, Josef Kleineidam, Luca Rodriguez, Francisca S. van den Bussche, Hendrik Schott, Björn H. Görß, Doreen Werle, Jochen Wagner, Michael Spruth, Eike J. Kilimann, Ingo Roy, Nina Brosseron, Frederic Roeske, Sandra Yakupov, Renat Ewers, Michael Kaduszkiewicz, Hanna Düzel, Emrah Maier, Franziska Ramirez, Alfredo Jessen, Frank Forstmeier, Simon Zulka, Linn E. Bickel, Horst Heneka, Michael T. Wiltfang, Jens Luppa, Melanie Buerger, Katharina Teipel, Stefan Schneider, Anja Maier, Wolfgang Scherer, Martin Fliessbach, Klaus Glanz, Wenzel Bartels, Claudia Lohse, Andrea Laske, Christoph Riedel-Heller, Steffi G. Munk, Matthias H. J. Janowitz, Daniel Fuchs, Angela Kobeleva, Xenia Altenstein, Slawek Unterfeld, Chantal Wiese, Birgitt Perneczky, Robert Wolfsgruber, Steffen Pentzek, Michael König, Hans-Helmut Incesoy, Enise I. Brettschneider, Christian Weyerer, Siegfried Rauchmann, Boris-Stephan Weyrauch, Anne-Sophie Erdogan, Selin
AuthorAffiliation	13 German Center for Neurodegenerative Diseases (DZNE) , Berlin , Germany 4 Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen , Siegen , Germany 33 Department of Psychosomatic Medicine, Rostock University Medical Center , Rostock , Germany 35 Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany 15 Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC) , Berlin , Germany 28 Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany 8 Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University , Heidelberg , Germany 2 German Center for Neurodegenerative Diseases (DZNE) , Bonn , Germany 19 Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen , Goettingen , Germany 20 German Center for Neurodegener
AuthorAffiliation_xml	– name: 6 Medical Faculty, Institute of General Practice, University of Kiel , Kiel , Germany – name: 11 Department of Psychiatry and Psychotherapy, School of Medicine, Technical University of Munich , Munich , Germany – name: 28 Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich , Munich , Germany – name: 34 German Center for Neurodegenerative Diseases (DZNE) , Tübingen , Germany – name: 18 University of Edinburgh and UK DRI , Edinburgh , United Kingdom – name: 13 German Center for Neurodegenerative Diseases (DZNE) , Berlin , Germany – name: 37 Department of Neurology, University of Bonn , Bonn , Germany – name: 38 Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne , Cologne , Germany – name: 32 German Center for Neurodegenerative Diseases (DZNE) , Rostock , Germany – name: 31 Sheeld Institute for Translational Neuroscience (SITraN), University of Sheeld , Sheeld , United Kingdom – name: 25 Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University , Magdeburg , Germany – name: 1 Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn , Bonn , Germany – name: 19 Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen , Goettingen , Germany – name: 30 Ageing Epidemiology Research Unit (AGE), School of Public Health, Imperial College London , London , United Kingdom – name: 4 Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen , Siegen , Germany – name: 5 Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 33 Department of Psychosomatic Medicine, Rostock University Medical Center , Rostock , Germany – name: 17 Department of Psychiatry and Psychotherapy, Charité—Universitätsmedizin Berlin , Berlin , Germany – name: 14 Department of Psychiatry, Campus Berlin-Buch, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH) , Berlin , Germany – name: 22 Department of Medical Sciences, Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), University of Aveiro , Aveiro , Portugal – name: 8 Medical Faculty, Central Institute of Mental Health, Mannheim/Heidelberg University , Heidelberg , Germany – name: 40 Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases , San Antonio, TX , United States – name: 10 Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf , Hamburg , Germany – name: 20 German Center for Neurodegenerative Diseases (DZNE) , Goettingen , Germany – name: 26 German Center for Neurodegenerative Diseases (DZNE) , Munich , Germany – name: 36 Department of Biology, Technische Universität Darmstadt , Darmstadt , Germany – name: 16 Department of Psychiatry, Campus Benjamin Franklin, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH) , Berlin , Germany – name: 21 Leibniz Institute for Neurobiology , Magdeburg , Germany – name: 15 Memory Clinic and Dementia Prevention Center, Experimental and Clinical Research Center (ECRC) , Berlin , Germany – name: 12 Medical Faculty, Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig , Leipzig , Germany – name: 29 Munich Cluster for Systems Neurology (SyNergy) , Munich , Germany – name: 3 Department of Psychology and Centre for Ageing and Health (AgeCap), University of Gothenburg , Gothenburg , Sweden – name: 23 Department of Psychiatry, Medical Faculty, University of Cologne , Cologne , Germany – name: 2 German Center for Neurodegenerative Diseases (DZNE) , Bonn , Germany – name: 27 Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich , Munich , Germany – name: 9 Medical Faculty, Centre for Health and Society (CHS), Institute of General Practice (ifam), Heinrich Heine University , Düsseldorf , Germany – name: 35 Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen , Tübingen , Germany – name: 39 Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne , Cologne , Germany – name: 7 Center for Information Management, Hannover Medical School , Hanover , Germany – name: 24 German Center for Neurodegenerative Diseases (DZNE) , Magdeburg , Germany
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Copyright	Copyright © 2022 Kleineidam, Wolfsgruber, Weyrauch, Zulka, Forstmeier, Roeske, van den Bussche, Kaduszkiewicz, Wiese, Weyerer, Werle, Fuchs, Pentzek, Brettschneider, König, Weeg, Bickel, Luppa, Rodriguez, Freiesleben, Erdogan, Unterfeld, Peters, Spruth, Altenstein, Lohse, Priller, Fliessbach, Kobeleva, Schneider, Bartels, Schott, Wiltfang, Maier, Glanz, Incesoy, Butryn, Düzel, Buerger, Janowitz, Ewers, Rauchmann, Perneczky, Kilimann, Görß, Teipel, Laske, Munk, Spottke, Roy, Brosseron, Heneka, Ramirez, Yakupov, Scherer, Maier, Jessen, Riedel-Heller and Wagner. Copyright © 2022 Kleineidam, Wolfsgruber, Weyrauch, Zulka, Forstmeier, Roeske, van den Bussche, Kaduszkiewicz, Wiese, Weyerer, Werle, Fuchs, Pentzek, Brettschneider, König, Weeg, Bickel, Luppa, Rodriguez, Freiesleben, Erdogan, Unterfeld, Peters, Spruth, Altenstein, Lohse, Priller, Fliessbach, Kobeleva, Schneider, Bartels, Schott, Wiltfang, Maier, Glanz, Incesoy, Butryn, Düzel, Buerger, Janowitz, Ewers, Rauchmann, Perneczky, Kilimann, Görß, Teipel, Laske, Munk, Spottke, Roy, Brosseron, Heneka, Ramirez, Yakupov, Scherer, Maier, Jessen, Riedel-Heller and Wagner. 2022 Kleineidam, Wolfsgruber, Weyrauch, Zulka, Forstmeier, Roeske, van den Bussche, Kaduszkiewicz, Wiese, Weyerer, Werle, Fuchs, Pentzek, Brettschneider, König, Weeg, Bickel, Luppa, Rodriguez, Freiesleben, Erdogan, Unterfeld, Peters, Spruth, Altenstein, Lohse, Priller, Fliessbach, Kobeleva, Schneider, Bartels, Schott, Wiltfang, Maier, Glanz, Incesoy, Butryn, Düzel, Buerger, Janowitz, Ewers, Rauchmann, Perneczky, Kilimann, Görß, Teipel, Laske, Munk, Spottke, Roy, Brosseron, Heneka, Ramirez, Yakupov, Scherer, Maier, Jessen, Riedel-Heller and Wagner
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Keywords	occupation mid-life cognitive demands Alzheimer's disease brain maintenance brain reserve cognitive reserve
Language	English
License	Copyright © 2022 Kleineidam, Wolfsgruber, Weyrauch, Zulka, Forstmeier, Roeske, van den Bussche, Kaduszkiewicz, Wiese, Weyerer, Werle, Fuchs, Pentzek, Brettschneider, König, Weeg, Bickel, Luppa, Rodriguez, Freiesleben, Erdogan, Unterfeld, Peters, Spruth, Altenstein, Lohse, Priller, Fliessbach, Kobeleva, Schneider, Bartels, Schott, Wiltfang, Maier, Glanz, Incesoy, Butryn, Düzel, Buerger, Janowitz, Ewers, Rauchmann, Perneczky, Kilimann, Görß, Teipel, Laske, Munk, Spottke, Roy, Brosseron, Heneka, Ramirez, Yakupov, Scherer, Maier, Jessen, Riedel-Heller and Wagner. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
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Snippet	Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have been... Introduction: Several lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects... IntroductionSeveral lifestyle factors promote protection against Alzheimer's disease (AD) throughout a person's lifespan. Although such protective effects have...
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SubjectTerms	Alzheimer's disease brain maintenance brain reserve cognitive reserve mid-life cognitive demands occupation Psychology Psykologi
Title	Midlife occupational cognitive requirements protect cognitive function in old age by increasing cognitive reserve
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