Satisfaction with current status at work and lack of motivation to improve it during midlife is associated with increased risk for dementia in subjects who survived thirty-seven years later

The present study aimed to assess the relationship of midlife Motivation to Improve Status at work (MIS) with dementia more than three decades later. In 1963, 9,920 out of 10,059 male participants of the Israel Ischemic Heart disease (IIHD) study, aged 40-65 years, were questioned about their MIS as follows: 'Do you want to improve your status at work and do you believe it is possible?'. One of four answers was possible: trying to change status and believe it is possible (MIS1) (n = 3,060); trying but unsure of success (MIS2) (n = 2,618); not trying, unlikely to succeed (MIS3) (n = 2,020); not trying, satisfied (MIS4) (n = 2,222). Dementia was assessed over three decades later in 1,714 survivors of the original cohort, including 1,691 who responded in 1963 to the questionnaire regarding MIS. Controlling for age, the estimated odds for dementia relative to MIS1 were 1.45 (95% CI 1.06-2.01) in MIS2, 1.52 (95% CI 1.04-2.23) in MIS3, and 1.96 (95% CI 1.38-2.81) in MIS4. Further adjustment for age and socioeconomic status index resulted in adjusted estimated odds for dementia relative to MIS1 were 1.26 (95% CI 0.90-1.75) in MIS2, 1.10 (95% CI 0.74-1.64) in MIS3, and 1.78 (95% CI 1.23-2.56) in MIS4. These results were not attenuated when midlife diabetes, blood pressure values, serum-cholesterol levels, and coronary heart disease were controlled for in the analysis. Among tenured working men, lack of MIS together with satisfaction with current status was associated with higher risk for dementia among survivors several decades later. This association was partially attenuated by socioeconomic status.