BMJ: It's best to use your brain at work!

A dilemma that workers often face is how to choose between high-paying dislikes and low-paying jobs? Harm, young people who were already struggling, now have one more dimension to refer to! It is whether the work can be trained to the brain~Recently, Professor Kivimäki from University College London and others published important research results in the journal BMJ[1].
Based on research data spanning Europe and the United States, covering 100,000+ participants, they found , People who work with high cognitive stimulation are at a lower risk of developing dementia than those who work with low cognitive stimulation
.

High education level + high cognitive stimulation work is associated with a 37% reduction in the risk of dementia
.

More importantly, the research team also identified three "harmful proteins" from nearly 5,000 proteins, and then explained the potential causes of this phenomenon from a neurobiological level
.

The 2020 report of the Lancet Committee shows that cognitive stimulation can help protect cognitive function or reduce the risk of dementia [2]
.

However, from previous research data, the evidence that cognitive activities during leisure are related to the prevention of dementia is often insufficient [3-5]
.

Researchers speculate that this may be related to the insufficient frequency/intensity of cognitive stimulation during leisure time.
If the research scene is transferred to work, it will be very different
.

After all, for our dignified workers, the cognitive stimulation at work can last for decades (if you don't retire early), which is much longer than the cognitive stimulation generated by leisure time hobbies
.

So what kind of mystery is hidden between cognitive stimulation and dementia at work? With this question in mind, Professor Kivimäki and others explored and analyzed the following three sets of correlations: ①Cognitive stimulation at work & new onset dementia, ②Cognitive stimulation at work & plasma protein, ③plasma protein & new onset dementia
.

However, how to define the degree of cognitive stimulation at work? According to Karasek’s demand control model [6], “active” jobs with high cognitive stimulation include high-demand and high-decision jobs, while “passive” jobs with low cognitive stimulation refer to those with low requirements and lack of Decision-making work
.

High-demand, low-decision or low-demand, high-decision is defined as medium cognitive stimulation
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After working for so many years, I discovered today that I still have so much knowledge about working.
The next question is, where do the data on working workers come from? Thanks to the IPD-Work Alliance established in 2008, this collaborative research project of 13 European cohort studies is dedicated to assessing the relationship between work-related factors and chronic diseases, disability and mortality
.

Seven of the cohort studies (GAZEL, WOLF, HeSSup, HHS, Whitehall II, FPS, Still Working) contained data on cognitive stimulation and the risk of dementia at work
.

On this basis, and then excluding the lost population and dementia patients, Professor Kivimäki and others conducted an analysis on the remaining 107,896 people
.

The average follow-up time of the participants ranged from 13.
7 to 30.
1 years, and 1143 people eventually developed dementia
.

Studies have found that people who work with high cognitive stimulation have a lower cumulative risk of dementia at the same age.
In other words, the age at which they develop dementia is also delayed
.

There was no significant difference between the low and medium cognitive stimulation groups
.

Compared with low- and medium-level cognitive stimulation, high-level cognitive stimulation can delay the onset of dementia.
From the incidence of dementia per 10,000 person-years, the low cognitive stimulation group is 7.
3 and the high cognitive stimulation group is 4.
8.
After adjusting for age and gender, the hazard ratio was 0.
77 (95% CI: 0.
65-0.
92)
.

Correction for education level, other risk factors for dementia (smoking, alcohol abuse, lack of exercise, work stress, obesity, high blood pressure, baseline diabetes), and factors such as cardiometabolic diseases (diabetes, coronary heart disease, stroke) before the diagnosis of dementia After that, the hazard ratio was 0.
82 (95% CI: 0.
68-0.
98)
.

A number of previous studies have shown that education level is negatively correlated with the occurrence of dementia [7-9]
.

Therefore, Professor Kivimäki and others combined education level and cognitive stimulation at work into a single variable, including low education level-low cognitive stimulation work (as a control group), low education level-high cognitive stimulation work, high education Level-low cognitive stimulation work, high education level-high cognitive stimulation work
.

When using Cox regression analysis, after adjusting for age and gender, it is not difficult to find that cognitive stimulation has a "dose" correlation with the risk of dementia
.

Compared with the low education level + low cognitive stimulation work group, the risk ratio of the high education level + high cognitive stimulation work group is 0.
63, while the high education level + low cognitive stimulation work group, and the low education level + high cognition work group The hazard ratios of stimulating work were 0.
73 and 0.
80, respectively
.

Maintaining a high level of cognitive stimulation for a long time, that is, studying and working with both hands, can prevent the risk of dementia to the greatest extent.
After revealing that high cognitive stimulation can reduce the risk of dementia, researchers began to turn their attention to the biological level
.

They used the 4953 plasma protein data of 2261 participants in the Whitehall II study subgroup for analysis.
After adjusting for age, gender, and race, they found that the levels of 6 proteins in the high cognitive stimulation group were significantly lower than those in the low cognitive stimulation group
.

 SP-D: lung surfactant-related protein D, SLIT2: slit homologous protein 2, HXK2: hexokinase 2, CHSTC: carbohydrate sulfotransferase 12, AMD: peptidylglycine α-amidating monooxygenase , NCF-1: Neutrophil Cytoplasmic Factor 1 Among nearly 5000 proteins, only these 6 proteins stand out, which makes researchers deeply doubt their role in dementia
.

Therefore, in addition to the 2,261 people in the Whithal II subgroup, the researchers also included 11,395 people in the ARIC cohort study for analysis
.

Among them, the ARIC study included participants' protein and follow-up data on the onset of dementia, but no data related to cognitive stimulation at work
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After adjusting for age, gender, and race, the analysis showed that high levels of the three proteins SLIT2, CHSTC, and AMD were associated with an increased risk of dementia
.

After hard work, the researchers finally discovered three key proteins: SLIT2, CHSTC and AMD.
Experimental results of past stem cells, tissue culture and animal models showed that SLIT2, CHSTC and AMD are associated with axon production, inhibition of synaptic connections, and nerves.
The mechanism of degenerative disease is related [10-12]
.

It is inferred from this that the low levels of these three "harmful" proteins may mediate the correlation between high cognitive stimulation and low risk of dementia
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As the researcher in this article concluded [13]: "High cognitive stimulation is related to the reduction of certain plasma protein levels, and these proteins may inhibit the production of axons and synapses, thereby increasing the risk of dementia in the human body.
This finding is May provide clues to the underlying biological mechanism"
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Cognitive stimulation in the workplace, plasma proteins, and risk of dementia: three analyses of population cohort studies.
BMJ.
2021;374:n1804.
Published 2021 Aug 18.
doi:10.
1136/bmj.
n1804.
[2] Livingston G, Huntley J, Sommerlad A, et al.
Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.
Lancet.
2020;396(10248):413 -446.
doi:10.
1016/S0140-6736(20)30367-6.
[3] Sommerlad A, Sabia S, Livingston G, Kivimäki M, Lewis G, Singh-Manoux A.
Leisure activity participation and risk of dementia: An 18 -year follow-up of the Whitehall II Study [published correction appears in Neurology.
2021 Apr 27;96(17):828].
Neurology.
2020;95(20):e2803-e2815.
doi:10.
1212/WNL.
0000000000010966.
[4] Floud S, Balkwill A, Sweetland S,