Background Both psychosocial stress at work and sleep disturbance may predispose impaired cognitive function and dementia in later life. However, whether sleep plays a mediating role for the link between stress at work and subsequent dementia has yet to be investigated. Methods Data from the Survey of Health, Ageing and Retirement in Europe were used for the study. A cohort of 7799 dementia-free individuals (aged 71.1±0.2 years) were followed up for a median of 4.1 years for incident dementia. Job demand and control were estimated using questions derived from the Karasek’s Job Content Questionnaire. Sleep disturbance was ascertained by a question in the EURO-Depression scale. Cox proportional hazard models adjusted for age, sex, education, cognitive test score, and other potential covariates were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) of dementia in relation to different job strain levels. Results An interaction between job demand and sleep disturbance regarding the risk of dementia was detected. Data suggested a protective role of high-level job demand for dementia in individuals with sleep disturbance (HR [95%CI]: 0.69 [0.47, 1.00]) compared with low job demand. A four-category job strain model based on the combination of job demand and job control levels suggested that among individuals with sleep disturbance, passive job (low demand, low control) was associated with a higher risk of dementia (1.54 [1.01, 2.34]), compared to active job (high demand, high control). Conclusion The link between work related stress and risk of dementia is limited to individuals suffering sleep disturbance.

中文翻译：

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睡眠调节工作压力与痴呆症之间的关联：来自欧洲健康、老龄化和退休调查的研究

背景 工作中的社会心理压力和睡眠障碍都可能导致晚年认知功能受损和痴呆。然而，睡眠是否在工作压力与随后的痴呆症之间的联系中起中介作用还有待研究。方法 本研究使用了欧洲健康、老龄化和退休调查的数据。对 7799 名无痴呆症个体（年龄 71.1±0.2 岁）的队列进行了随访，随访时间为 4.1 年，以发现痴呆症事件。工作需求和控制是使用从 Karasek 的工作内容问卷中得出的问题来估计的。睡眠障碍是通过欧洲抑郁量表中的一个问题来确定的。Cox 比例风险模型根据年龄、性别、教育程度、认知测试分数进行调整，和其他潜在协变量用于估计与不同工作压力水平相关的痴呆症的风险比 (HR) 和 95% 置信区间 (CI)。结果 检测到工作需求和睡眠障碍之间关于痴呆风险的相互作用。数据表明，与低工作需求相比，高水平工作需求对睡眠障碍患者的痴呆症具有保护作用（HR [95%CI]：0.69 [0.47, 1.00]）。基于工作需求和工作控制水平组合的四类工作压力模型表明，在有睡眠障碍的个体中，被动工作（低需求、低控制）与更高的痴呆风险相关（1.54 [1.01, 2.34] )，与主动工作（高要求、高控制）相比。