Association Between Job Adaptation According to Education Level and Cognitive Decline in Middle-Aged and Older Workers

BACKGROUND: Workplace factors across middle and later life may influence cognitive aging and later-life cognitive change. We examined associations of job - education adaptation with global cognitive function (MMSE) in middle-aged and older Korean workers. METHODS: Using KLoSA (2008-2020), we analyzed 3,322 participants aged ≥45 years employed. Repeated MMSE scores were modeled with generalized estimating equations adjusted for sociodemographic, health, and covariates. Job adaptation was cross-classified with education (≤middle school/high school/≥college). Sensitivity and subgroup analyses by sex and age ( < 65 vs ≥ 65) were performed. RESULTS: Job - education mismatch predicted lower MMSE scores. Compared with Neutral - high school, High-≤middle-school (β = -1.737, 95% CI - 2.669 to -0.804), Low-≤middle-school (β = -1.392, 95% CI - 1.613 to -1.171), and Neutral-≤middle-school (β = -1.227, 95% CI - 1.371 to -1.082) had poorer cognition. Effects were larger in subgroups: females (High-≤middle-school β = -2.357, 95% CI - 3.948 to -0.766), those ≥65 (High-≤middle-school β = -2.144, 95% CI - 3.622 to -0.666), and white-collar (Neutral-≤middle-school β = -2.135, 95% CI - 2.857 to -1.413). Results were robust to sensitivity checks. CONCLUSION: Job - education mismatch is associated with worse global cognitive function, notably among women, older adults, and some occupational groups. Policies improving person - job fit and skill use may mitigate cognitive decline.