European Journal of Epidemiology

, Volume 29, Issue 5, pp 353–361 | Cite as

Older age at retirement is associated with decreased risk of dementia

  • Carole DufouilEmail author
  • Edwige Pereira
  • Geneviève Chêne
  • M. Maria Glymour
  • Annick Alpérovitch
  • Elodie Saubusse
  • Mathilde Risse-Fleury
  • Brigitte Heuls
  • Jean-Claude Salord
  • Marie-Anne Brieu
  • Françoise Forette


To test the hypothesis that age at retirement is associated with dementia risk among self-employed workers in France, we linked health and pension databases of self-employed workers and we extracted data of those who were still alive and retired as of December 31st 2010. Dementia cases were detected in the database either through the declaration of a long-term chronic disease coded as Alzheimer’s disease and other dementia (International Classification of Disease codes G30, F00, F01, F03) or through the claim for reimbursement of one of the anti-dementia drugs. Data were analyzed using Cox proportional hazard model adjusting for potential confounders. Among the 429,803 retired self-employed workers alive on December 31st 2010, prevalence of dementia was 2.65 %. Multivariable analyses showed that the hazard ratio 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). We 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. Further evidence is necessary to evaluate whether this association is causal, but our results indicate the potential importance of maintaining high levels of cognitive and social stimulation throughout work and retiree life.


Dementia Cognitive reserve Prevention Intellectual stimulation 



This study was initiated by ILC-France and supported by funds provided by Ipsen Pharma, Van Dyck Health Care, Groupe PREVOIR, Lündbeck SAS, Nutricia Nutrition Clinique (groupe Danone), HSBC France. The funding sources had no role in study design, data collection, analysis, interpretation, or writing of the report.

Conflict of interest

The authors declare that no competing interests exist.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Carole Dufouil
    • 1
    • 2
    • 3
    • 10
    Email author
  • Edwige Pereira
    • 1
    • 2
  • Geneviève Chêne
    • 1
    • 2
    • 3
  • M. Maria Glymour
    • 4
  • Annick Alpérovitch
    • 2
  • Elodie Saubusse
    • 5
  • Mathilde Risse-Fleury
    • 6
  • Brigitte Heuls
    • 7
  • Jean-Claude Salord
    • 8
  • Marie-Anne Brieu
    • 8
  • Françoise Forette
    • 8
    • 9
  1. 1.Centre INSERM U897-Epidemiologie-Biostatistique and CIC-EC7INSERM, ISPEDBordeauxFrance
  2. 2.Centre INSERM U897-Epidemiologie-BiostatistiqueISPED, Univ. BordeauxBordeauxFrance
  3. 3.Pôle de Santé PubliqueCHU de BordeauxBordeauxFrance
  4. 4.Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoUSA
  5. 5.Régime Social des IndépendantsBordeauxFrance
  6. 6.Régime Social des IndépendantsSaint-DenisFrance
  7. 7.Agence Nationale de sécurité du médicament et des produits de santéSaint-DenisFrance
  8. 8.International Longevity Centre-FranceParisFrance
  9. 9.University René DescartesParisFrance
  10. 10.INSERM U897 and CIC-EC7Bâtiment ISPED-Université de BordeauxBordeaux CédexFrance

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