Job Instability, Early Retirement Tied to Dementia Risk

Columbia University's Mailman School of Public Health

September 23, 2026-- Stable employment in midlife was associated with better cognitive health in later life, according to a new study from Columbia University Mailman School of Public Health's Butler Aging Center. Conversely, employment instability, early retirement, and dropping out of the labor force are linked to significantly poorer cognitive outcomes.

Among men, inconsistent employment was associated with lower cognitive scores and greater odds of cognitive impairment, while among women, employment instability and early retirement were associated with lower executive function and memory scores. The findings are published in Alzheimer's & Dementia.

The results reveal that for men, an inconsistently employed history corresponds to a cognitive deficit equivalent to approximately seven years of cognitive aging. For women, experiencing early retirement or prolonged periods outside the labor force equates to roughly six years of memory deficits.

A critical, previously unanswered question in cognitive aging research was whether perceived job insecurity exerts an influence on brain health, above and beyond objective employment status. By tracking long-term employment trajectories, the Columbia researchers found that while both matter, maintaining employment continuity emerged as the more critical protective factor for cognitive health.

"By jointly characterizing labor force participation and perceived job insecurity over 16 years, our study captures the co-evolution of objective employment states and subjective work experiences in a way that prior studies have not, and these differences were substantial," said first author Erika Beidelman, PhD, postdoctoral research scientist at the Butler Columbia Aging Center. "Interestingly, our results suggest that employment continuity, rather than subjective job security, may be the more protective factor for cognitive aging."

Cognitive deficits and a greater risk of impairment were concentrated among older adults who exited the labor force early, stayed outside it, or shifted frequently across employment status.

The study also highlighted how employment experiences across midlife are highly gendered. Women are more likely to experience prolonged periods of non-participation in the formal labor force and interrupted employment trajectories, often reflecting historical differences and caregiving responsibilities. Men, by contrast, more often experience employment instability through involuntary job loss or inconsistent attachment to paid work.

"Importantly, exposure to long-term employment instability differs systematically by gender in exposure, and likely in its impact on cognitive health," Beidelman noted. "These differences underscore the necessity of examining gender-specific employment trajectories to understand late-life cognitive outcomes."

The researchers leveraged 16 years of longitudinal data (1998–2014) from the Health and Retirement Study (HRS), a nationally representative cohort of older Americans, alongside its 2016 Harmonized Cognitive Assessment Protocol (HCAP) sub-study. The final sample included 2,418 individuals; 1,470 women and 948 men, who were under age 65 at their first labor force status measurement. Participants were tracked across seven combined employment and job insecurity states, ranging from "Employed-Job Secure" and "Employed-Job Insecure" to "Unemployed" and "Not in Labor Force."

Across the subset of participants who completed the HCAP assessment in 2016, approximately 30 percent of women and 31 percent of men met the criteria for cognitive impairment, including mild cognitive impairment or dementia.

Prior studies have established that continued workforce participation preserves cognition, while unemployment and illness-driven instability increase dementia risk. "By embedding subjective job insecurity within long-term employment histories, this study provides a clearer picture of how psychosocial work dimensions unfold over decades," noted Beidelman.

"Our findings carry meaningful implications for dementia prevention and public health policy," Beidelman said. "Employment continuity across midlife may represent a modifiable factor associated with cognition decades later. Policies supporting sustained labor force attachment, reducing involuntary job transitions, and expanding access to cognitively engaging employment throughout midlife may help promote healthier cognitive aging."

Co-authors are Xuexin Yu and Yuan Zhang, Columbia Mailman School of Public Health; Constance Beaufils, King's College London; Rachel Donnelly, Vanderbilt University; Mateo Farina, University of Texas at Austin; and Amanda Sonnega and Lindsay Kobayashi, University of Michigan.

The study was supported by the National Institute on Aging [Grant #: RF1AG088005-01].

The authors have no conflicts of interest to declare.

Columbia University Mailman School of Public Health

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