Subjective cognitive complaints and permanent work disability: a prospective cohort study

Int Arch Occup Environ Health. 2021 Jul;94(5):901-910. doi: 10.1007/s00420-020-01643-1. Epub 2021 Jan 19.

Abstract

Purpose: Work disability (WD) is a medico-legal concept that refers to disability benefits (DB) granted due to diseases. We assessed whether subjective cognitive complaints (SCC)-presenting as self-rated difficulties of concentration, memory, clear thinking, and decision making-predict permanent WD in knowledge-intensive occupations.

Methods: In this prospective cohort study with up to 7-year follow-up, we combined the SCC questionnaire results with reliable registry data on the DBs of 7161 professional/managerial employees (46% females). We excluded employees who were on long-term sickness absence (SA) or had received a DB at baseline. The exposure variable was the presence of SCC. Age and SA before the questionnaire as a proxy measure of general health were treated as confounders and the analyses were conducted by gender. The outcome variable was a granted DB. The cumulative incidence function illustrates the difference between SCC categories, and the Fine-Gray model estimates the predictors of WD during the 8-year follow-up.

Results: The annual incidence of DB was 0.15% in the entire cohort: 0.18% among the females, and 0.12% among the males (p = 0.795). The most common primary reasons for permanent WD were mental (36%) and musculoskeletal (20%) disorders. SCC predicted DB in both genders when controlling for age and prior SA. Hazard ratios were 2.9 with a 95% confidence interval 1.4-6.0 for the females and 3.7 (1.8-7.9) for the males.

Conclusion: Subjective cognitive complaints predict permanent WD in knowledge-intensive occupations. This finding has implications for supporting work ability and preventing work disability among employees with cognitively demanding tasks.

Keywords: Cumulative incidence function; Disability retirement; Fine-Gray model; Occupational health care; Register data; Self-reported data; Subjective cognitive complaints.

MeSH terms

  • Adult
  • Aged
  • Cognition Disorders / epidemiology*
  • Female
  • Finland / epidemiology
  • Humans
  • Insurance, Disability / statistics & numerical data*
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / epidemiology
  • Occupations
  • Prospective Studies
  • Self Report
  • Sick Leave / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult

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