Early retirement may not be all it's cracked up to be. A large population-based study suggests that those who retire early have a significantly increased risk for cognitive decline, especially women. Results from a national survey of more than 17,000 individuals in rural China showed that those who took part in an early retirement pension program had significantly lower cognitive and memory scores compared to those who did not participate in the program. The negative effects associated with retirement were more pronounced among women, in whom the incidence of decline was twofold greater than the incidence in men. Although retirement is associated with a number of health benefits, the current study suggests that "it can also provide some adverse effects on quality of life associated with cognitive performance," principal investigator Plamen Nikolov, PhD, assistant professor of economics at Binghamton University, State University of New York, told Medscape Medical News. Nikolov noted that it's not clear whether the study results can be generalized to developed countries because the populations and environments in those countries are so different from those of rural China. Still, the study's overall findings are similar to those found in other research on cognition in retirees in the United States, the United Kingdom, and the European Union, the investigators write. The results were published online by the IZA Institute of Labor Economics. First Study of Its Kind The researchers note that the study is the first to examine the possible cognitive effects of pension participation in a developing country. Nikolov has conducted previous research on the effects of the Chinese retirement program on the overall health of participants and said he was surprised by the results. In previous studies, investigators found significant positive overall health effects of the Chinese retirement program, known as the New Rural Pension Scheme (NRPS). Nikolov said he expected that the retirement program and the resulting positive health effects "could slow down the decline in cognition and that results would be positive." However, the researchers found the opposite to be true. To assess cognitive abilities, the investigators analyzed data from the national Chinese Health and Retirement Longitudinal Survey, which included more than 17,000 participants aged 45 years or older. The survey, which is similar to one conducted in the United States, tests individual cognitive abilities, including memory. The survey includes a wide range of questions and asks whether the respondents were participating in the NRPS retirement program. "Important Implications" In participants aged 60 years or older, results showed that those from areas where the NRPS program was implemented scored significantly lower on all cognitive tests in comparison with persons from areas where there was no such program. Individuals in the retirement program areas scored an average of 0.14 points less on the immediate recall test, 0.23 to 0.25 points less on the delayed recall test, and 0.35 points less on the total recall test. The study also showed that scores were significantly lower among the older participants who directly reported participating in the retirement program. However, many survey respondents did not answer that question. Still, the findings "support the mental retirement hypothesis that decreased mental activity results in atrophy of cognitive skills and suggest that retirement plays a significant role in explaining cognitive decline at an older age," the researchers write. Comparing effect-size estimates, the difference between estimates in the subgroup of women was approximately double or more than the effect size for the subgroup of men. "This result has important implications for the welfare of women in rural China," the investigators write. Longevity is considerably higher in women than in men, "a pattern that is also true for individuals in our rural Chinese sample," they note. "Our findings suggest that early retirement is likely to accelerate cognitive declines in adulthood, which is likely to result in lower healthy life expectancy among women in rural China," they add. Overall, a decline in social interactions and social engagement as individuals retire may play a role in cognitive decline ― and those effects may be even more pronounced in rural China, said Nikolov. "It's a lot more difficult to maintain the same level of activity and mental fitness in areas that are obviously a lot less urban and less connected," he said. However, Nikolov added that variables that were not identified in the Chinese national survey and in the current study could have contributed to the cognitive declines. Still, he said, similar research may offer guidance to society, policy makers, and individual retirees. Policies might be implemented to encourage more social interaction among retired people and encourage more opportunities for older people to engage their brains as they did when they were employed, he noted. Such policies "may want to tackle the possible disengagement among individuals in rural areas by coupling the pension benefits program with some other policies that essentially buffer and reduce the likelihood of people disengaging from society when they retire," Nikolov said. No Causal Link Commenting on the findings for Medscape Medical News, Rebecca Edelmayer, PhD, director of scientific engagement for the Alzheimer's Association, said the results represent an important "piece of the puzzle" to help science understand some of the risk factors of cognitive decline. Understanding those risk factors, including in retirement, will help guide science in finding strategies to lower those risks, said Edelmayer, who was not involved with the research. "I think it's a very interesting paper," she said. However, the study did not prove a causal relationship between early retirement and cognitive decline, she added. Instead, it showed an association between the two. Edelmayer noted that many things can drive risk for cognitive decline and that age and retirement may be among the risk factors. However, it is likely that there are other variables not accounted for in the Chinese national survey that contribute to faster cognitive decline, she said. "It makes it a complex thing to try to understand. As we continue to look at more and more data, we need some really rigorous trials to help push this to the next level," she said. That would include learning more about what sort of mental engagement might be most helpful in holding off cognitive decline as people age and retire, Edelmayer said. Source
