Older Age at retirement is associated with decreased risk of dementia. Analysis of a healthcare insurance database of self-employed workers
Carole Dufouil, PhD - INSERM U708 & CIC-EC7, Bordeaux-France
Edwige Pereira, MSc - INSERM U708, Bordeaux-France
Geneviève Chêne, MD PhD - INSERM U897, Bordeaux-France
M. Maria Glymour, Sc D - Harvard School of Public Health, Boston-USA
Annick Alpérovitch, MD MSc - INSERM U708, Paris-France
Elodie Saubusse, MSc - RSI Aquitaine, Bruges-France
Mathilde Risse-Fleury, MD - RSI Saint-Denis-France
Brigitte Heuls, MD - RSI Saint-Denis-France
Jean-Claude Salord, MD - ILC France, Paris-France
Marie-Anne Brieu, MD - ILC France Paris-France
Francoise Forette, MD - ILC France, Paris - France
Background Intellectual stimulation and mental engagement throughout life might be protective against dementia. We investigated whether age at retirement influences dementia risk among self- employed workers in France. Methods We linked health and pension databases including self-employed workers who were living and retired as of December 31st 2010. Dementia cases were defined based either on ICD-10th diagnosis or on claim for one of the medication against dementia (donepezil, galantamine, rivastigmine). Data were analysed using Cox proportional hazard model where age at dementia diagnosis or age at censoring (31st December 2010) was the dependent variable and age of retirement was the independent variable. Hazard ratios were computed adjusting for gender, marital status, occupational category, type of retirement, pension amount, diagnosis of hypertension, diabetes. Sensitivity analyses to assess potential reverse causation and differential cohort or temporal diagnosis biases were undertaken. Results
Among the 429,803 retired self-employed workers alive on December 31st 2010, prevalence of dementia was 2.65%. Workers had been retired on average for more than 12 years. Multivariable analyses showed that the hazard ratio (HR) of dementia was 0.968 (95% Confidence Interval= [0.962-0.973]) per each extra year of age at retirement. After excluding workers who had dementia diagnosed within the 5 years following retirement, the results remained unchanged and highly significant (p<0.0001). Results were also similar in further analyses stratified by age categories or year of dementia diagnosis. Conclusions Professional activity may be an important determinant of mental exercise and social integration. Our data show strong evidence of a significant decrease in the risk of developing dementia associated with older age at retirement, in line with the "use it or lose it" hypothesis. This health perspective should be taken into consideration when the age of cessation of professional activity is discussed. Our results thus highlight the importance of maintaining high levels of cognitive and social stimulation throughout work and retiree life and emphasize the need for interventions and policies to help older individuals achieve such cognitive and social engagement.
THERMOSENSITIVE DOCETAXEL LIPOSOMES Xingguo Mei1, Qinwei Jiang1, Weiping Yu2 and Christopher D.V. Black21Beijing Institute of Pharmacology and Toxicology, 27, Taiping Road, Beijing, PRC 100850 2Celsion Corporation, 10220-L Old Columbia Road, Columbia, MD 21046. USA. We have developed a liposome preparation containing docetaxel that is designed to release its contents when subjected to mild
Introduction In large complex proceedings, such as class actions, there are many hidden reefs, there are cross winds and there are side winds. There is rarely plain sailing. Everyone, except the judge, is usually part of a well resourced team. The pot of gold can be large and the benefits for plaintiffs chasing that pot are significant. The pirates, though, are well armed, astute and