Subjective Cognitive Complaints and Permanent Work Disability: A Prospective Cohort Study of 7,161 Employees in Primarily Knowledge-intensive Occupations with an up to Eight-Year Follow-up

Abstract

Background: 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: We combined the SCC questionnaire results with reliable registry data on the DBs of 7,161 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 eight-year follow-up. Results: 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. After eight years, 3.1% of the females and 2.8% of the males in the abnormal SCC category had received a DB, while the respective figures in the reference category were 1.9% and 1.0%. Conclusion: Subjective cognitive complaints predict permanent WD in knowledge-intensive occupations among professional/managerial employees. This finding has implications for supporting work ability among employees with cognitively demanding tasks.