Abstract
BACKGROUND: The projected expansion of an aging United States (US) workforce prompts further evaluation of the potential impact of work on cognitive health. This study aimed to investigate longitudinal associations of reward and effort at work with subjective memory among US older workers. METHODS: Data were obtained from the population-based Health and Retirement Study. At the 2006-2008 baseline, effort and reward were measured using hypotheses based on the effort-reward imbalance (ERI) model. A subjective memory summary score that was composed of two items, in which higher scores indicated better subjective memory, was assessed biennially between the baseline and 2018. Generalized estimating equations analyzed longitudinal associations of effort and reward categories with changes in subjective memory between the baseline and follow-ups. Demographic, socioeconomic, lifestyle, health, and work covariates were adjusted for in linear regression models. Supplementary analyses explored the associations of ERI components with each of the two items that formed the subjective memory summary score. RESULTS: Among 3,497 workers aged 50 years and older, after covariate adjustments, high reward was significantly associated with better subjective memory (regression coefficient: 0.15 [95% confidence interval: 0.07, 0.23], p < 0.001). Compared to the combination of "low effort and low reward," other effort-reward combinations were also associated with increased subjective memory (p < 0.05). Supplementary analyses demonstrated significant positive associations with independent high reward and ERI combinations. High effort was positively related to subjective memory, although the association was not significant after adjustments. CONCLUSION: Work-related reward, independently and in combination with effort, may contribute to improved subjective memory among US older workers.