Work-Related Factors and Cognitive Health: Evidence-Based Insights for Organizational Practice

Jonathan H. Westover, PhD
5 hours ago
31 min read

Listen to this article:

Abstract: Cognitive functioning represents a critical determinant of worker performance, safety, and long-term neurological health. While cognitively stimulating work environments can promote healthy cognitive aging, several occupational factors demonstrate consistent detrimental effects on cognitive performance. This systematic review synthesizes evidence from 64 empirical studies examining relationships between work-related exposures and cognitive outcomes across multiple domains including attention, memory, executive function, and processing speed. Results indicate that shift work—particularly night shifts—occupational stress, and prolonged working hours consistently impair cognitive functioning through mechanisms including circadian disruption, chronic sleep deficiency, and stress-mediated neurophysiological changes. Evidence regarding sedentary work remains inconclusive due to methodological heterogeneity. Findings suggest workplace health promotion should prioritize shift schedule optimization, stress reduction interventions, working hour limitations, and recovery-oriented practices. These evidence-based modifications can protect cognitive health during working years while potentially mitigating early cognitive decline following retirement.

Cognitive functions—the mental capacities enabling attention, memory, learning, executive function, and language—underpin virtually every dimension of human activity. From remembering a phone number to executing complex professional tasks, cognitive abilities shape both work performance and quality of life. During working years, maintaining robust cognitive functioning proves essential not merely for productivity but crucially for preserving cognitive reserve that supports healthy aging after retirement (Cohen et al., 2019).

Contemporary research demonstrates that various lifestyle factors influence cognitive preservation across the lifespan. Physical activity, social engagement, mentally stimulating leisure activities, and cognitively complex occupations all contribute to building cognitive reserve—the brain's resilience against neuronal damage and age-related decline (Stern et al., 1995; Schooler et al., 1999; Ihle et al., 2015). Theoretical frameworks including the "use-it-or-lose-it" hypothesis, cognitive reserve theory, and Schooler's environmental influence model converge on a fundamental principle: cognitively engaging environments throughout working life promote intellectual development and protect against decline (Schooler, 1984; Hultsch et al., 1999; Stern, 2002; Salthouse, 2006).

However, this normative aging trajectory can be disrupted when work itself introduces factors that actively impair cognitive functioning. Prolonged stress exposure triggers glucocorticoid-mediated hippocampal changes resulting in cognitive impairment (McEwen & Sapolsky, 1995). Sleep disturbances—including acute deprivation and chronic deficiency—demonstrably deteriorate cognitive performance (Wang et al., 2021; Brownlow et al., 2020). Sedentary behavior associates with lower cognitive performance, though mechanisms remain partially understood (Falck et al., 2017). Each of these risk factors may be intrinsically embedded in specific work arrangements.

The Stakes: Individual and Organizational Consequences

The implications extend beyond individual wellbeing to organizational performance and public safety. Healthcare workers experiencing shift-related cognitive impairment face increased medical error risk. Transportation workers with attention deficits pose traffic safety concerns. Office workers with stress-induced executive dysfunction demonstrate reduced decision-making quality and productivity. These immediate performance impacts compound with long-term consequences: occupational exposures accelerating cognitive decline threaten workers' independence, health, and quality of life following retirement.

Recognizing these interconnected risks, the European community has prioritized healthy aging workforce initiatives (Vendramin et al., 2012; Belin et al., 2016), stimulating research examining which work-related factors most significantly compromise cognitive health. Despite growing interest, the literature remains fragmented across multiple occupational domains, populations, and cognitive outcomes—creating challenges for evidence-based intervention design.

This systematic review addresses this gap by comprehensively synthesizing empirical evidence on work-related factors affecting cognitive functions, thereby enabling practitioners and organizations to identify priority areas for intervention and understand the magnitude of cognitive risks embedded in contemporary work arrangements.

The Occupational Cognitive Health Landscape

Defining Work-Related Cognitive Risk in Occupational Contexts

Work-related cognitive risk encompasses employment conditions, schedules, demands, and exposures that demonstrably impair cognitive performance through measurable, quantifiable assessment. Unlike general workplace stress or dissatisfaction, cognitive risk specifically targets neuropsychological functioning across domains including sustained attention, working memory, processing speed, executive functions, and decision-making capacity.

The systematic review by Bufano et al. (2024) identified five distinct categories of work-related cognitive risk emerging from empirical research:

Shift work: Employment schedules maintaining operations beyond standard daytime hours, particularly overnight shifts causing circadian rhythm disruption
Occupational stress: Sustained exposure to job demands and pressures exceeding workers' resources and control, potentially culminating in burnout
Sedentary work: Roles requiring prolonged sitting with minimal physical movement throughout work periods
Prolonged working hours: Extended shift durations or excessive weekly hours pervading workers' non-work time
Expertise effects: Differential cognitive impacts associated with experience levels and job complexity

Prevalence, Drivers, and Distribution

Shift work affects approximately 20-25% of European and North American workforces, concentrated in healthcare, emergency services, transportation, manufacturing, and hospitality sectors. The International Labour Organization estimates that shift work arrangements continue expanding globally, driven by 24-hour economic demands and service expectations. Healthcare workers—nurses, physicians, emergency personnel—represent the most extensively studied population due to both high shift work prevalence and occupational complexity.

Occupational stress demonstrates near-universal prevalence across sectors, though manifestation varies by role demands, autonomy, and organizational resources. High-demand, low-control positions in healthcare, social services, education, emergency response, and customer-facing roles show elevated stress-related cognitive impairment risk. The Health and Safety Executive estimates work-related stress accounts for significant productivity losses and healthcare costs across developed economies.

Sedentary work predominates in office-based roles, administrative positions, and computer-intensive occupations. Modern workplace trends toward desk-based activity and screen time have substantially increased sedentary exposure prevalence. However, sedentary behavior often co-occurs with other risk factors (poor diet, inadequate physical activity outside work), complicating causal attribution.

Prolonged working hours vary substantially by occupation, cultural norms, and employment contracts. Medical residents, attorneys, financial sector professionals, and managerial roles commonly experience extended hours. While regulatory frameworks limit working hours in some contexts (e.g., European Working Time Directive), enforcement remains inconsistent and exemptions exist for specific professions.

Expertise and cognitive complexity effects distribute unevenly: intellectually demanding professions (management, professional services, creative industries) may benefit from cognitive stimulation, while highly routine, physically demanding roles provide less cognitive protection despite accumulated experience.

Organizational and Individual Consequences of Work-Related Cognitive Impairment

Organizational Performance Impacts

The organizational consequences of work-related cognitive impairment extend across safety, quality, productivity, and workforce sustainability dimensions.

Safety and Error Rates

Research demonstrates that shift workers—particularly healthcare professionals—show significantly elevated error risks following overnight shifts. Studies of anesthesia residents revealed 24-hour shifts impaired reaction time, problem-solving, attention, and mental flexibility (Abdelhamid et al., 2020; Adams & Venter, 2020). Emergency physicians working 24-hour shifts exhibited significantly greater cognitive impairment than those working 14-hour shifts (Persico et al., 2018). These cognitive deficits translate directly to clinical decision-making quality and patient safety outcomes.

Beyond healthcare, transportation and manufacturing sectors face comparable risks. Shift workers' impaired vigilance, slowed reaction times, and reduced attention increase accident likelihood and reduce quality control effectiveness. Meta-analytic evidence suggests that night shift work increases workplace accident risk by 30-50% compared to day shifts.

Productivity and Decision Quality

Occupational stress significantly reduces cognitive performance across multiple domains. Healthcare workers experiencing burnout demonstrated impaired executive functioning, particularly cognitive flexibility—essential for adapting to changing clinical situations (Cano-López et al., 2023; Farahat et al., 2022). Prolonged working hours similarly compromise performance: workers exceeding 55 hours weekly showed lower scores on reasoning and vocabulary assessments and accelerated cognitive decline over five-year follow-up compared to 40-hour-per-week peers (Virtanen et al., 2009).

These cognitive impairments reduce workers' capacity for complex problem-solving, strategic thinking, and adaptive decision-making—core competencies for knowledge work and professional roles. Organizations employing cognitively impaired workers face reduced innovation capacity, poorer strategic choices, and diminished competitive advantage.

Workforce Sustainability

Perhaps most concerning, evidence suggests work-related cognitive risks accelerate long-term decline, potentially shortening effective working lifespan and increasing early retirement. Rouch et al. (2005) found long-term shift work exposure associated with poorer verbal memory and processing speed in a large cross-sectional study. Titova et al. (2016) demonstrated that shift work history linked to worse cognitive performance in middle-aged and older adults. These findings suggest cognitive impacts persist beyond immediate shift exposures, potentially compromising workers' capacity to sustain employment through later career stages.

Individual Wellbeing and Stakeholder Impacts

Worker Health and Quality of Life

Individual workers bear the most direct consequences of work-related cognitive impairment. Cognitive deficits compromise daily functioning beyond the workplace: impaired memory affects medication adherence and household management; reduced attention increases driving accident risk; executive dysfunction undermines financial decision-making and long-term planning.

Sleep disruption from shift work creates cascading health consequences including increased cardiovascular disease risk, metabolic disorders, and mental health conditions—each potentially contributing to further cognitive impairment (Kantermann et al., 2012; Picano et al., 2014). Chronic occupational stress associates with anxiety, depression, and burnout, which both result from and contribute to cognitive difficulties (Golonka et al., 2019).

Long-term cognitive health represents perhaps the most consequential individual outcome. Early cognitive decline compromises independence, reduces quality of life, and increases dementia risk. Occupational exposures that accelerate cognitive aging effectively shorten individuals' cognitively healthy lifespan following retirement—the period many expect to enjoy after decades of work.

Family and Social System Impacts

Cognitive impairment affects not only workers but their families and social networks. Shift work disrupts family routines, reduces availability for childcare and household responsibilities, and strains relationships. Cognitive deficits from stress or extended hours compromise workers' capacity for emotional regulation and social engagement, potentially degrading relationship quality.

When work-related factors precipitate early cognitive decline, family members increasingly assume caregiving responsibilities—often while simultaneously managing their own occupational demands. These cascading effects distribute cognitive health risks across social networks and generations.

Evidence from Systematic Review: Work-Related Risk Factors

This section presents findings from the 64 empirical studies included in the systematic review examining work-related factors and cognitive functioning. Evidence is organized by the five identified risk categories.

Shift Work and Cognitive Functions

The systematic review included 39 studies examining shift work effects on cognitive performance. Studies consistently demonstrated that shift work—particularly night shifts—impairs multiple cognitive domains through circadian disruption and sleep deficiency mechanisms.

Key findings across populations:

Among healthcare workers, multiple studies documented cognitive impairment following shift work:

Anesthesia residents showed declined reaction time, problem-solving, attention, and mental flexibility after night shifts (Abdelhamid et al., 2020; Adams & Venter, 2020; Prasad et al., 2021)
Nurses demonstrated affected reaction time, motor ability, attention, cognitive flexibility, working memory, and decision-making after work shifts (Chang et al., 2011, 2013a,b; Niu et al., 2013; James et al., 2021; Sun et al., 2021; An et al., 2022; Esmaily et al., 2022; Peng et al., 2022)
Physicians across specialties (intensivists, emergency doctors, gynaecologists, junior doctors, hospital doctors, medical house officers) exhibited deficits in attention, executive function, memory, motor function, and reaction time after night shifts (Deary & Tait, 1987; Orton & Gruzelier, 1989; Lingenfelser et al., 1994; Anderson et al., 2012; Özdemir et al., 2013; Veddeng et al., 2014; Maltese et al., 2016; Persico et al., 2018; Benítez-Provedo et al., 2022)

Among other occupational groups:

Security staff showed impaired visuo-spatial memory, cognitive flexibility, and sustained attention (Vajravelu et al., 2016; Athar et al., 2020)
Control room operators demonstrated reduced working memory performance and increased reaction time (Kazemi et al., 2016, 2018; Haidarimoghadam et al., 2017)
Business process outsourcing employees performed poorly on tests of mental speed, learning, memory, and response inhibition (Shwetha & Sudhakar, 2012, 2014)
Power plant workers, petrochemical workers, firefighters, police employees, and miners all showed impairment in one or more cognitive functions following shift work (Smith et al., 1995; Rouch et al., 2005; Soares & de Almondes, 2017; Taylor et al., 2019; Stout et al., 2021; Zhao et al., 2021)

Notable pattern findings:

Chang et al. (2011) found greater impairment of perceptual and motor ability after two consecutive night shifts compared with four consecutive night shifts, suggesting recovery patterns may not be linear. Kazemi et al. (2018) demonstrated that control room operators working seven consecutive night shifts maintained better cognitive performance than those working four consecutive nights—indicating optimal shift block configuration matters.

One divergent finding emerged: Petru et al. (2005) found no immediate negative effects on cognitive and psychomotor performance of night shift workers compared with early-late shift workers when night shifts were voluntarily chosen, suggesting autonomy may moderate some effects.

Cognitive domains most consistently affected:

Sustained attention and vigilance
Working memory
Reaction time and processing speed
Executive functions (cognitive flexibility, decision-making)
Perceptual-motor abilities

Occupational Stress and Cognitive Functions

Twelve studies examined occupational stress effects on cognitive performance, demonstrating consistent associations between stress/burnout and cognitive impairment across diverse occupational contexts.

Key findings:

Healthcare professionals experiencing work-related stress showed multiple cognitive impacts:

Primary healthcare professionals with burnout demonstrated executive dysfunction (Cano-López et al., 2023)
Healthcare workers on the front line during COVID-19 pandemic exhibited impaired cognitive executive functioning due to stress (Farahat et al., 2022)
Hospital workers with job stress showed impaired memory retrieval (Vuori et al., 2014)

Cross-sectional and longitudinal evidence:

Large-scale studies provided population-level evidence:

Among 9,969 middle-aged workers, work-related stress associated with lower performance on delayed recall, verbal fluency, and executive function tests (de Souza-Talarico et al., 2020)
In the Whitehall II cohort of 4,146 civil servants, high-strain jobs (high demands, low control) associated with lower cognitive performance, though associations diminished after adjusting for employment grade (Elovainio et al., 2009)
A 12-year follow-up study across 13,349 European adults found both high-strain and passive jobs associated with lower cognitive ability (episodic memory and verbal fluency), with long exposure to passive jobs or moderate high-strain job duration associated with lower cognitive ability and accelerated decline (Zhuo et al., 2021)

Specific occupational groups:

Beyond healthcare, stress-cognition relationships appeared across diverse roles:

Police officers showed working memory deficits related to occupational stress (Gutshall et al., 2017)
Jockeys with higher occupational stress demonstrated decrements in decision-making (Landolt et al., 2017)
Farmworkers experienced stress as an important risk factor for poor cognitive function (Nguyen et al., 2012)
Young workers experiencing workplace stress showed decreased cognitive functions (Gafarov et al., 2021)

Burnout-specific findings:

Several studies specifically examined burnout—representing extreme stress exposure:

Patients with work-related stress complaints showed mildly reduced performance across all neuropsychological test domains compared to stress-free controls (Eskildsen et al., 2015)
Burnout associated with difficulties in voluntary control over attention, with difficulty severity varying with burnout symptom severity (Van Der Linden et al., 2005)

Cognitive domains most consistently affected:

Executive functions (particularly cognitive flexibility)
Memory (both immediate and delayed recall)
Sustained attention and concentration
Processing speed
Verbal fluency

Sedentary Work and Cognitive Functions

Seven studies examined sedentary work and cognitive performance relationships, producing inconclusive and heterogeneous findings that prevent definitive conclusions.

Mixed findings:

Several studies found no significant cognitive effects:

Russell et al. (2016) found no statistically significant differences in cognitive performance or work efficiency between sitting and standing conditions over five consecutive days
Baker et al. (2018c) observed no substantial correlations between discomfort and cognitive function during two hours of prolonged sitting, though musculoskeletal discomfort increased
Baker et al. (2018b) found that movement interventions during prolonged standing provided no advantage in discomfort or cognitive function

Studies showing cognitive decrements:

Baker et al. (2018a) found sustained attention reaction time deteriorated during prolonged standing, though creative problem-solving improved
John et al. (2009) demonstrated treadmill walking caused 6-11% decrease in fine motor skills and impaired math problem solving, with no effects on selective attention, processing speed, or reading comprehension
Ohlinger et al. (2011) found that adding walking tasks to cognitive activities reduced motor speed performance but did not alter immediate recall or selective attention performance

Positive associations with physical activity:

Bojsen-Møller et al. (2019) found moderate-to-vigorous physical activity (MVPA) duration associated with better selective attention performance in office workers, but results did not support hypotheses that more MVPA time or less sedentary behavior time associated with better overall cognitive function

Interpretation challenges:

The heterogeneity in findings likely reflects:

Methodological differences in assessment timing, cognitive domains evaluated, and study duration
Individual differences in habitual activity levels and postural tolerance
Interactive effects between sedentary behavior, physical fitness, diet, and other health behaviors
Discomfort potentially mediating relationships between posture and cognition rather than sedentary behavior per se

Prolonged Working Hours and Cognitive Functions

Three studies examined prolonged working hours effects, consistently demonstrating cognitive impairment associated with extended shifts and excessive weekly hours.

Key findings:

Extended daily hours:

Ansiau et al. (2008) found working before 6 AM or after 10 PM on the previous day significantly associated with poorer cognitive performance (verbal memory, processing speed, selective attention) the following day among 2,337 workers
Proctor et al. (1996) demonstrated increased overtime work significantly associated with impaired performance on attention and executive function tests among automotive workers, independent of other factors

Excessive weekly hours:

Virtanen et al. (2009) examined 2,214 civil servants and found working more than 55 hours per week (compared to 40 hours maximum) associated with lower scores on vocabulary tests at baseline and follow-up, and predicted decline in reasoning test performance over five years

Mechanisms implicated: These studies suggest prolonged working hours affect cognition through:

Accumulated sleep deficiency when long hours reduce recovery time
Increased stress from work-life conflict and reduced personal time
Direct fatigue effects during extended shifts
Insufficient recovery between work periods

Cognitive domains affected:

Verbal memory
Processing speed
Selective attention
Executive functions (particularly reasoning)
Vocabulary/crystallized intelligence

Expertise and Cognitive Functions

Three studies examined how work expertise and experience relate to cognitive performance, producing context-dependent findings.

Positive expertise effects:

Colonia-Willner (1998) found expert bank managers demonstrated better performance on intelligence domain assessments (particularly tacit knowledge) compared to non-expert managers, with abstract and verbal reasoning higher among experts—suggesting stabilization of some intelligence aspects may occur with expertise in older workers

Neutral findings:

Ovaskainen and Heikkilä (2007) found no cognitive ability differences between professional timber harvester operators and student operators, though professionals demonstrated substantially higher productivity—suggesting expertise manifests in skill mastery rather than superior cognitive abilities

Mixed age-expertise findings:

Wagner-Hartl et al. (2018) found older white-collar workers (with more experience) demonstrated slower reaction times and more frequent errors compared to younger workers, though differences were modest

Interpretation: These findings suggest experience effects depend heavily on work type:

Intellectually demanding work may provide cognitive benefits through continued stimulation
Physically demanding or highly routine work shows neutral associations despite accumulated experience
Experience alone does not guarantee cognitive enhancement—cognitive complexity matters more than tenure

Table 1: Work-Related Factors and Their Impact on Cognitive Health

Work-Related Factor	Occupational Groups Studied	Cognitive Domains Affected	Key Findings and Impairments	Proposed Biological Mechanisms	Recommended Organizational Interventions
Shift work (particularly night shifts)	Healthcare workers (nurses, physicians, anesthesia residents), security staff, control room operators, BPO employees, power plant workers, miners, police, firefighters	Sustained attention, vigilance, working memory, reaction time, processing speed, executive functions (flexibility, decision-making), perceptual-motor abilities	Significant impairments in reaction time and problem-solving after night shifts; increased accident risk by 30–50%; long-term exposure linked to poorer verbal memory and decline in older adults	Circadian rhythm disruption and chronic sleep deficiency	Forward-rotating shift schedules; limiting consecutive night shifts to 2–3 nights; minimum 48 hours recovery time; voluntary shift selection; fatigue risk management systems
Occupational stress and burnout	Primary healthcare professionals, frontline COVID-19 workers, hospital staff, civil servants, police officers, jockeys, farmworkers	Executive functions (cognitive flexibility), memory (immediate and delayed recall), sustained attention, concentration, processing speed, verbal fluency	High-strain jobs associated with lower cognitive performance; burnout leads to difficulties in voluntary control over attention; accelerated decline linked to long exposure to passive or high-strain jobs	Glucocorticoid-mediated hippocampal changes and stress-mediated neurophysiological changes	Increasing job control and decision latitude; enhancing social support; right-sizing workloads; providing stress management training; creating psychologically safe climates
Prolonged working hours	Automotive workers, civil servants, medical residents, attorneys, financial professionals	Verbal memory, processing speed, selective attention, executive functions (reasoning), vocabulary/crystallized intelligence	Working >55 hours/week associated with lower vocabulary scores and accelerated reasoning decline over 5 years; overtime linked to impaired attention	Accumulated sleep deficiency, increased stress from work-life conflict, and direct fatigue	Maximum shift lengths (12h for demanding work; 8h for safety-critical); 48-hour weekly maximum; schedule predictability; mandatory rest periods
Expertise and Cognitive Complexity	Bank managers, timber harvester operators, white-collar workers	Intelligence domains (tacit knowledge), abstract reasoning, verbal reasoning, reaction time	Intellectually demanding work stabilizes intelligence aspects in older experts; routine work shows no cognitive enhancement from tenure; experience does not guarantee protection if complexity is low	Cognitive reserve theory and the "use-it-or-lose-it" hypothesis	Rotating assignments to ensure variety; continuous professional development; job crafting; encouraging problem-solving over routine tasks
Sedentary work	Office workers, administrative positions, computer-intensive occupations	Sustained attention, fine motor skills, math problem solving, creative problem-solving	Findings are inconclusive and heterogeneous; some studies show treadmill walking decreases motor skills by 6–11%, others show no significant cognitive differences between sitting and standing	Partially understood; potentially mediated by musculoskeletal discomfort rather than posture itself	Sit-stand workstations; regular movement breaks (5 mins/hour); walking meetings; promoting non-work physical activity

Translating Evidence to Practice: Organizational Responses

The systematic review evidence clearly identifies shift work, occupational stress, and prolonged working hours as priority intervention targets. This section translates research findings into practical organizational approaches. Note: The interventions and organizational examples described below represent evidence-informed practice recommendations and illustrative cases, not empirical studies from the systematic review itself.

Shift Schedule Optimization and Night Shift Reduction

Given overwhelming evidence that shift work—particularly night shifts—impairs cognitive functioning, organizations should prioritize schedule optimization as a primary intervention.

Evidence-informed approaches include:

Implementing forward-rotating shift schedules (day → evening → night rather than backward rotation) to better align with circadian rhythms
Limiting consecutive night shifts to reduce cumulative sleep deficiency; research suggests maximum blocks of 2-3 consecutive nights before recovery periods
Providing sufficient recovery time between shift blocks—minimum 48 hours following night shift sequences to enable circadian re-entrainment
Offering voluntary night shift selection when feasible, recognizing that autonomy may enable workers to optimize personal circadian preferences (Petru et al., 2005)
Scheduling cognitively demanding tasks during optimal circadian phases, avoiding 3-4 AM when alertness naturally reaches minimum
Implementing fatigue risk management systems that monitor cumulative hours and establish performance criteria for safety-critical tasks

Healthcare systems internationally have experimented with various shift length reforms, moving from 12-hour to 8-hour shifts or establishing mandatory rest periods between shifts, reporting improvements in error rates and worker fatigue. Airlines have restructured crew scheduling to limit consecutive night flights and provide extended recovery periods. Some emergency services have piloted flexible rostering enabling workers to negotiate shift preferences based on individual chronotype while maintaining operational coverage.

Stress Reduction Through Job Redesign and Resource Enhancement

The job demands-resources model provides a framework for understanding how cognitive impairment emerges when work demands persistently exceed available resources. Multiple studies demonstrated associations between high-strain jobs and lower cognitive performance (Elovainio et al., 2009; de Souza-Talarico et al., 2020; Zhuo et al., 2021).

Evidence-informed approaches include:

Increasing job control and decision latitude by enabling workers to influence task sequencing, methods, and pacing
Enhancing social support systems through team-based work structures, peer support programs, and accessible supervision
Right-sizing workloads through realistic staffing ratios, appropriate caseload limits, and systematic workload monitoring
Providing adequate recovery opportunities including scheduled breaks, appropriate vacation time, and protection of non-work hours from work intrusion
Implementing stress management training offering evidence-based techniques (cognitive reframing, mindfulness, relaxation training)
Establishing clear role definitions and expectations to reduce role ambiguity and conflict
Creating psychologically safe climates where workers can acknowledge stress without stigma or career consequences

Healthcare organizations have implemented comprehensive clinician wellness programs addressing systemic stressors through workload redistribution, enhanced administrative support, peer support groups, and protected professional development time. Some customer service operations have restructured to enhance employee autonomy and reduce monotonous task exposure through expanded decision authority and skill rotation. Hospital systems have implemented systematic caseload monitoring and dynamic resource allocation, deploying additional temporary staffing when cognitive demand indicators exceed predetermined thresholds.

Working Hour Limits and Schedule Predictability

Evidence consistently demonstrates cognitive impairment associated with extended shifts and excessive weekly hours (Ansiau et al., 2008; Proctor et al., 1996; Virtanen et al., 2009).

Evidence-informed approaches include:

Implementing maximum shift lengths (e.g., 12-hour maximum for cognitively demanding work; 8-hour maximum for safety-critical roles)
Establishing weekly working hour limits (e.g., 48-hour maximum) with monitoring systems ensuring compliance
Providing schedule predictability through advance notice of shift assignments
Compensating extended hours with recovery time rather than purely financial compensation
Restricting consecutive days worked (e.g., maximum 6 consecutive workdays) to enable weekly recovery cycles
Creating organizational norms that discourage excessive hours and recognize limits as productivity optimization

European countries have established maximum working hours, mandatory rest periods, and night shift frequency limits through legislation and collective agreements. Some hospitals have implemented physician work hour reforms including 16-hour maximum shifts for interns and mandatory 8-hour rest periods between shifts. Professional services firms increasingly implement "core hours" for client work, "protected time" free from meetings, and explicit guidance that responsiveness expectations do not extend to evenings and weekends except for designated on-call periods.

Sedentary Work Considerations

Given inconclusive evidence from the systematic review regarding sedentary work effects on cognition, organizations should approach this area with appropriate caution while recognizing musculoskeletal and cardiovascular benefits of movement.

Approaches to consider (acknowledging evidence limitations):

Implementing sit-stand workstations enabling posture variation throughout the day
Scheduling regular movement breaks (e.g., 5 minutes per hour) for stretching or walking
Designing meeting formats incorporating walking meetings or stand-up meetings for brief discussions
Promoting non-work physical activity through workplace fitness facilities, active commuting support, and wellness programs
Educating workers about musculoskeletal health and postural variation benefits

While research shows mixed findings on direct cognitive effects of sedentary work, cardiovascular fitness demonstrates established cognitive benefits. Organizations should frame movement initiatives primarily around cardiovascular health and musculoskeletal comfort rather than overstating direct cognitive performance claims.

Recovery-Oriented Work Design

While not systematically reviewed as a separate intervention category, the evidence strongly suggests that cognitive resources deplete during sustained task engagement and require restoration. Organizations can build recovery opportunities into work design.

Recovery-supporting approaches include:

Legitimizing breaks through explicit policies and managerial support
Providing dedicated spaces for brief rest, relaxation, or light physical activity away from work settings
Building breaks into workflow through natural task transitions or predetermined intervals
Monitoring break patterns to ensure workers utilize opportunities rather than working through rest periods
Educating managers about cognitive resource depletion and restoration

Some technology companies provide on-site amenities (fitness facilities, meditation rooms, outdoor spaces) designed to support brief recovery activities. Healthcare settings increasingly provide dedicated quiet rooms and explicitly encourage 10-15 minute breaks during long shifts with coverage scheduled to enable genuine disengagement.

Building Long-Term Cognitive Resilience and Organizational Sustainability

Beyond addressing specific risk factors, organizations can cultivate work environments and practices that systematically support cognitive health across working lifespan. This section explores three forward-looking pillars for organizational strategy.

Psychological Contract Recalibration: From Boundless Availability to Sustainable Performance

Traditional employment norms increasingly expect boundless availability—constant connectivity, rapid responsiveness, and willingness to extend work into personal time. These expectations directly threaten cognitive health by preventing recovery, sustaining stress, and disrupting sleep. Organizations committed to cognitive health must fundamentally renegotiate psychological contracts to establish sustainable performance as the goal rather than maximal availability.

Principles and practices:

Establishing "right to disconnect" policies that legitimize non-responsiveness outside core working hours
Modeling boundaries at leadership levels, with executives visibly maintaining work-life boundaries
Measuring performance through quality and outcomes rather than hours worked or availability metrics
Designing workflows that accommodate reasonable response timeframes
Creating redundancy and coverage systems enabling genuine disconnection during vacation
Explicitly discussing recovery as performance necessity in onboarding and management training

This recalibration recognizes that cognitive capability—not mere presence—determines work quality, and that cognitive capability requires genuine recovery periods protected from work intrusion.

Distributed Leadership and Autonomy: Reducing Concentrated Stress Exposure

Highly centralized decision-making concentrates stress and cognitive demands on small numbers of individuals—typically senior leaders and managers. Distributing decision authority, leadership responsibilities, and problem-solving across organizational levels reduces concentrated exposure while potentially enhancing overall organizational cognitive capacity.

Principles and practices:

Implementing team-based or shared leadership models rather than single-point leadership structures
Expanding decision-making authority to frontline workers for operational choices within defined parameters
Rotating leadership responsibilities for projects or initiatives
Creating participatory decision processes for strategic choices
Flattening organizational hierarchies to reduce approval bottlenecks
Providing decision support systems enabling distributed decision-making with appropriate information
Establishing clear boundaries defining which decisions require centralized approval

Beyond stress reduction, distributed leadership potentially enhances organizational resilience by developing broader leadership capacity and reducing dependence on cognitively overloaded key individuals.

Continuous Learning Systems and Cognitive Complexity

Aligning with cognitive reserve theory, organizations can systematically provide cognitive stimulation and learning opportunities that build mental capital. While recognizing limitations in extrapolating from normative aging research to organizational practice, emerging evidence suggests cognitively complex work environments may offer some protective effects.

Principles and practices:

Rotating assignments and responsibilities to expose workers to varied challenges and learning opportunities
Providing training and development throughout careers, not only early stages
Encouraging problem-solving and innovation rather than purely routine task execution
Creating opportunities for collaboration across disciplines and specialties
Implementing job crafting practices enabling workers to shape roles toward areas of interest and challenge
Recognizing expertise while avoiding rigid specialization that reduces cognitive variety
Supporting career transitions and new role exploration

Importantly, cognitive complexity differs from cognitive overload—the goal involves challenging engagement, not overwhelming demands. Organizations must carefully balance cognitive stimulation with manageable demands and adequate resources.

Conclusion

This systematic review reveals that multiple work-related factors significantly affect cognitive functioning, with implications extending across immediate performance, long-term cognitive health, and organizational outcomes. The evidence base demonstrates clear, consistent patterns for several risk categories while highlighting areas requiring further investigation.

Shift work, particularly night shifts, demonstrably impairs attention, working memory, reaction time, executive function, and decision-making through circadian disruption and sleep deficiency mechanisms. The 39 included studies consistently document cognitive deficits across diverse occupations and countries, with healthcare workers representing the most extensively studied population. Organizations employing shift workers should prioritize schedule optimization, forward rotation, limited consecutive night shifts, adequate recovery periods, and voluntary selection when feasible.

Occupational stress shows strong, consistent associations with cognitive impairment across memory, attention, executive function, and processing speed domains. Burnout—representing extreme stress exposure—significantly compromises higher-order cognitive processes essential for complex work. The 12 included studies span healthcare, emergency services, agricultural work, and other sectors, demonstrating stress-cognition relationships across contexts. Evidence-based responses include job redesign enhancing resources and control, workload management, social support enhancement, and psychologically safe organizational climates.

Prolonged working hours consistently associate with cognitive performance decrements and potentially accelerated long-term decline. Though only three studies met inclusion criteria, their large samples and longitudinal designs provide compelling evidence that excessive hours compromise cognitive health. Organizations should establish maximum daily and weekly hour limits, provide schedule predictability, and ensure adequate recovery time between work periods.

Evidence regarding sedentary work remains inconclusive. Seven included studies demonstrate substantial methodological heterogeneity and mixed findings—some showing no cognitive effects, others suggesting performance decrements with standing or walking interventions. Current evidence cannot definitively guide practice regarding direct cognitive effects, suggesting organizations should focus primarily on musculoskeletal health and cardiovascular fitness benefits of movement.

Expertise effects prove highly context-dependent, with intellectual work potentially providing cognitive benefits while physically demanding routine work shows neutral or negative associations. The three included studies suggest experience alone does not guarantee cognitive enhancement—cognitive complexity and novelty matter more than tenure.

Actionable Organizational Priorities

Based on evidence strength and consistency, organizations seeking to protect worker cognitive health should prioritize:

Shift schedule reform for operations involving night work, implementing forward rotation, limited consecutive nights, extended recovery periods, and voluntary selection when possible
Systematic stress assessment and reduction through job redesign, appropriate staffing, workload monitoring, and resource enhancement
Working hour limits and enforcement establishing maximum daily shifts and weekly hours with monitoring systems
Recovery-oriented work design legitimizing breaks and building restoration opportunities into workflows
Long-term cognitive health integration into workplace health promotion, recognizing cognitive functioning as a core health outcome

Implications for Practice and Policy

These findings carry implications beyond individual organizational practice. Occupational health regulations should consider cognitive functioning alongside traditional physical safety and exposure concerns. Professional licensing and credentialing bodies might establish work hour limits for practitioners in safety-critical roles. Labor agreements could incorporate cognitive health protections including schedule requirements and stress-reduction provisions.

Workplace health promotion programs should expand beyond traditional cardiovascular disease, musculoskeletal health, and mental health domains to explicitly address cognitive functioning. Assessment tools, interventions, and outcome measures should evaluate cognitive health as distinct from general mental health.

Future Research Directions

Several research needs emerge from this synthesis:

Methodological standardization for sedentary work studies would enable clearer conclusions about sitting-cognition relationships. Future research should isolate sedentary behavior from confounding factors, use consistent cognitive assessment batteries, and examine both immediate and long-term outcomes.

Longitudinal studies tracking workers across careers and into retirement would clarify whether occupational exposures accelerate cognitive aging and increase dementia risk. Current evidence suggests potential long-term impacts but lacks sufficient follow-up duration and comprehensive outcome assessment.

Intervention trials testing specific organizational changes could provide stronger causal evidence than existing observational studies. Randomized or quasi-experimental designs evaluating shift schedule modifications, stress reduction interventions, and working hour limits would strengthen recommendations.

Economic analyses quantifying costs of cognitive impairment versus intervention costs would support business case development. Current evidence demonstrates adverse outcomes but rarely translates findings to economic terms compelling for organizational decision-making.

Developing country research would establish whether patterns observed in developed economies generalize across different regulatory environments, cultural contexts, and occupational distributions.

Concluding Perspective

Work represents a double-edged sword for cognitive health: it can provide stimulation, structure, social connection, and purpose supporting cognitive vitality—or it can impose demands, disruptions, and stressors that compromise cognitive functioning and accelerate decline. Organizations increasingly recognize that worker health constitutes strategic capability rather than cost burden. Cognitively healthy workers demonstrate superior performance, safety, innovation, and adaptability compared to cognitively impaired peers.

Protecting cognitive health during working years offers profound implications extending beyond employment to post-retirement quality of life, independence, and societal contribution. Workers spending decades in occupations that systematically degrade cognitive functioning face shortened cognitively healthy lifespans and potentially increased dementia risk. Conversely, careers characterized by manageable demands, adequate resources, restorative schedules, and cognitive stimulation may build cognitive reserve protecting against age-related decline.

The evidence synthesized in this review demonstrates that work-related cognitive impairment is neither inevitable nor necessary. Organizations possessing knowledge of risk factors can choose to design work that protects rather than damages cognitive health. These choices determine not only organizational performance but workers' long-term flourishing—a responsibility warranting serious attention from leaders, policymakers, and practitioners committed to sustainable, humane work systems.

Research Infographic

Cognitive Capital Crisis

References

Abdelhamid, B. M., Omar, H., Hassan, M. M., Embaby, S. A., Rady, A., & Mohamed Aly, H. (2020). Effects of partial sleep deprivation following night shift on cognitive functions of Egyptian anesthesiologists: Prospective observational study. Egyptian Journal of Anaesthesia, 36, 61–68.
Adams, T. P., & Venter, S. (2020). All night long: An assessment of the cognitive effects of night shift work in anaesthesiology trainees. Southern African Journal of Anaesthesia and Analgesia, 26, 287–292.
An, R., Li, C., Ai, S., Wu, Y., Luo, X., Li, X., et al. (2022). Effect of shift work on fatigue, reaction time and accuracy of nurses in the Department of Neurology: A cross-sectional observational study. Journal of Nursing Management, 30, 2074–2083.
Anderson, C., Sullivan, J. P., Flynn-Evans, E. E., Cade, B. E., Czeisler, C. A., & Lockley, S. W. (2012). Deterioration of neurobehavioral performance in resident physicians during repeated exposure to extended duration work shifts. Sleep, 35, 1137–1146.
Ansiau, D., Wild, P., Niezborala, M., Rouch, I., & Marquié, J. C. (2008). Effects of working conditions and sleep of the previous day on cognitive performance. Applied Ergonomics, 39, 99–106.
Athar, M. E., Atef-Vahid, M.-K., & Ashouri, A. (2020). The influence of shift work on the quality of sleep and executive functions. Journal of Circadian Rhythms, 18, 1–8.
Baker, R., Coenen, P., Howie, E., Lee, J., Williamson, A., & Straker, L. (2018a). A detailed description of the short-term musculoskeletal and cognitive effects of prolonged standing for office computer work. Ergonomics, 61, 877–890.
Baker, R., Coenen, P., Howie, E., Lee, J., Williamson, A., & Straker, L. (2018b). Musculoskeletal and cognitive effects of a movement intervention during prolonged standing for office work. Human Factors, 60, 947–961.
Baker, R., Coenen, P., Howie, E., Williamson, A., & Straker, L. (2018c). The short term musculoskeletal and cognitive effects of prolonged sitting during office computer work. International Journal of Environmental Research and Public Health, 15, 1678.
Belin, A., Dixon, K., Davis, A., Graveling, R., Dupont, C., Crawford, J., et al. (2016). The ageing workforce: Implications for occupational safety and health: A research review. Luxembourg: Publication Office of the European Union.
Benítez-Provedo, C., Talavera, B., García-Azorín, D., & Marcos-Dolado, A. (2022). The cognitive impact of guard shifts in physicians: A before-after study. Neurological Sciences, 43, 1701–1708.
Bojsen-Møller, E., Boraxbekk, C.-J., Ekblom, Ö., Blom, V., & Ekblom, M. M. (2019). Relationships between physical activity, sedentary behaviour and cognitive functions in office workers. International Journal of Environmental Research and Public Health, 16, 4721.
Brownlow, J. A., Miller, K. E., & Gehrman, P. R. (2020). Insomnia and cognitive performance. Sleep Medicine Clinics, 15, 71–76.
Bufano, P., Di Tecco, C., Fattori, A., Barnini, T., Comotti, A., Ciocan, C., Ferrari, L., Mastorci, F., Laurino, M., & Bonzini, M. (2024). The effects of work on cognitive functions: A systematic review. Frontiers in Psychology, 15, 1351625.
Cano-López, I., Pérez, M. I., & Puig-Pérez, S. (2023). Burnout is related to executive dysfunction in primary healthcare professionals working in rural areas. Revista de Neurología, 76, 91–99.
Chang, Y.-S., Chen, H.-L., Hsu, C.-Y., Su, S.-F., Liu, C.-K., & Hsu, C. (2013a). Nurses working on fast rotating shifts overestimate cognitive function and the capacity of maintaining wakefulness during the daytime after a rotating shift. Sleep Medicine, 14, 605–613.
Chang, Y.-S., Wu, Y.-H., Su, S.-F., Hsu, C.-Y., & Chen, H.-L. (2013b). Factors related with the ability to maintain wakefulness in the daytime after fast and forward rotating shifts. Kaohsiung Journal of Medical Sciences, 29, 611–616.
Chang, Y. S., Wu, Y. H., Hsu, C. Y., Tang, S. H., Yang, L. L., & Su, S. F. (2011). Impairment of perceptual and motor abilities at the end of a night shift is greater in nurses working fast rotating shifts. Sleep Medicine, 12, 866–869.
Cohen, R. A., Marsiske, M. M., & Smith, G. E. (2019). Neuropsychology of aging. In Handbook of Clinical Neurology (Vol. 167, pp. 149–180). Elsevier.
Colonia-Willner, R. (1998). Practical intelligence at work: Relationship between aging and cognitive efficiency among managers in a bank environment. Psychology and Aging, 13, 45–57.
de Souza-Talarico, J. N., Suemoto, C. K., Santos, I. S., Griep, R. H., Yamaguti, S. T. F., Lotufo, P. A., et al. (2020). Work-related stress and cognitive performance among middle-aged adults: The Brazilian longitudinal study of adult health (ELSA-Brasil). Stress and Health, 36, 19–30.
Deary, I. J., & Tait, R. (1987). Effects of sleep disruption on cognitive performance and mood in medical house officers. British Medical Journal, 295, 1513–1516.
Elovainio, M., Feme, J. E., Singh-Manoux, A., Gimeno, D., De Vogli, R., Shipley, M. J., et al. (2009). Cumulative exposure to high-strain and active jobs as predictors of cognitive function: The Whitehall II study. Occupational and Environmental Medicine, 66, 32–37.
Eskildsen, A., Andersen, L. P., Pedersen, A. D., Vandborg, S. K., & Andersen, J. H. (2015). Work-related stress is associated with impaired neuropsychological test performance: A clinical cross-sectional study. Stress, 18, 198–207.
Esmaily, A., Jambarsang, S., Mohammadian, F., & Mehrparvar, A. H. (2022). Effect of shift work on working memory, attention and response time in nurses. International Journal of Occupational Safety and Ergonomics, 28, 1085–1090.
Falck, R. S., Davis, J. C., & Liu-Ambrose, T. (2017). What is the association between sedentary behaviour and cognitive function? A systematic review. British Journal of Sports Medicine, 51, 800–811.
Farahat, S. A., Amin, O. R., Hamdy, H. S., & Fouad, M. M. (2022). The impact of work-related stress on the cognition domain of executive functioning of health care workers during the COVID-19 pandemic. International Archives of Occupational and Environmental Health, 95, 1079–1090.
Fratiglioni, L., & Wang, H.-X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimer's Disease, 12, 11–22.
Gafarov, V. V., Sukhanov, A. V., Gromova, E. A., Panov, D. O., Denisova, D. V., Gagulin, I. V., et al. (2021). Workplace stress and cognitive functions (a population based study of adults aged 25-44 years). Nevrologiya, Neiropsikhiatriya, Psikhosomatika, 13, 30–36.
Golonka, K., Mojsa-Kaja, J., Blukacz, M., Gawłowska, M., & Marek, T. (2019). Occupational burnout and its overlapping effect with depression and anxiety. International Journal of Occupational Medicine and Environmental Health, 32, 229–244.
Gutshall, C. L., Hampton, D. P. Jr., Sebetan, I. M., Stein, P. C., & Broxtermann, T. J. (2017). The effects of occupational stress on cognitive performance in police officers. Police Practice and Research, 18, 463–477.
Haidarimoghadam, R., Kazemi, R., Motamedzadeh, M., Golmohamadi, R., Soltanian, A., & Zoghipaydar, M. R. (2017). The effects of consecutive night shifts and shift length on cognitive performance and sleepiness: A field study. International Journal of Occupational Safety and Ergonomics, 23, 251–258.
Hultsch, D. F., Hertzog, C., Small, B. J., & Dixon, R. A. (1999). Use it or lose it: Engaged lifestyle as a buffer of cognitive decline in aging? Psychology and Aging, 14, 245–263.
Ihle, A., Oris, M., Fagot, D., Baeriswyl, M., Guichard, E., & Kliegel, M. (2015). The association of leisure activities in middle adulthood with cognitive performance in old age: The moderating role of educational level. Gerontology, 61, 543–550.
James, L., Elkins-Brown, N., Wilson, M., James, S. M., Dotson, E., Edwards, C. D., et al. (2021). The effects of three consecutive 12-hour shifts on cognition, sleepiness, and domains of nursing performance in day and night shift nurses: A quasi-experimental study. International Journal of Nursing Studies, 123, 104041.
John, D., Bassett, D., Thompson, D., Fairbrother, J., & Baldwin, D. (2009). Effect of using a treadmill workstation on performance of simulated office work tasks. Journal of Physical Activity and Health, 6, 617–624.
Kantermann, T., Wehrens, S. M. T., Ulhôa, M. A., Moreno, C., & Skene, D. J. (2012). Noisy and individual, but doable: Shift-work research in humans. Progress in Brain Research, 199, 399–411.
Kazemi, R., Haidarimoghadam, R., Motamedzadeh, M., Golmohamadi, R., Soltanian, A., & Zoghipaydar, M. R. (2016). Effects of shift work on cognitive performance, sleep quality, and sleepiness among petrochemical control room operators. Journal of Circadian Rhythms, 14, 1–8.
Kazemi, R., Motamedzade, M., Golmohammadi, R., Mokarami, H., Hemmatjo, R., & Heidarimoghadam, R. (2018). Field study of effects of night shifts on cognitive performance, salivary melatonin, and sleep. Safety and Health at Work, 9, 203–209.
Landolt, K., Maruff, P., Horan, B., Kingsley, M., Kinsella, G., O'Halloran, P. D., et al. (2017). Chronic work stress and decreased vagal tone impairs decision making and reaction time in jockeys. Psychoneuroendocrinology, 84, 151–158.
Lingenfelser, T., Kaschel, R., Weber, A., Zaiser-Kaschel, H., Jakober, B., & Küper, J. (1994). Young hospital doctors after night duty: Their task-specific cognitive status and emotional condition. Medical Education, 28, 566–572.
Maltese, F., Adda, M., Bablon, A., Hraeich, S., Guervilly, C., Lehingue, S., et al. (2016). Night shift decreases cognitive performance of ICU physicians. Intensive Care Medicine, 42, 393–400.
McEwen, B. S., & Sapolsky, R. M. (1995). Stress and cognitive function. Current Opinion in Neurobiology, 5, 205–216.
Nguyen, H. T., Quandt, S. A., Grzywacz, J. G., Chen, H., Galván, L., Kitner-Triolo, M. H., et al. (2012). Stress and cognitive function in Latino farmworkers. American Journal of Industrial Medicine, 55, 707–713.
Niu, S.-F., Chu, H., Chen, C.-H., Chung, M.-H., Chang, Y.-S., Liao, Y.-M., et al. (2013). A comparison of the effects of fixed-and rotating-shift schedules on nursing staff attention levels: A randomized trial. Biological Research for Nursing, 15, 443–450.
Ohlinger, C. M., Horn, T. S., Berg, W. P., & Cox, R. H. (2011). The effect of active workstation use on measures of cognition, attention, and motor skill. Journal of Physical Activity and Health, 8, 119–125.
Orton, D. I., & Gruzelier, J. H. (1989). Adverse changes in mood and cognitive performance of house officers after night duty. British Medical Journal, 298, 21–23.
Ovaskainen, H., & Heikkilä, M. (2007). Visuospatial cognitive abilities in cut-to-length single-grip timber harvester work. International Journal of Industrial Ergonomics, 37, 771–780.
Özdemir, P. G., Selvi, Y., Özkol, H., Aydin, A., Tülüce, Y., Boysan, M., et al. (2013). The influence of shift work on cognitive functions and oxidative stress. Psychiatry Research, 210, 1219–1225.
Peng, J., Lu, H., Zhang, J., Shao, Y., Wang, L., & Lv, J. (2022). Need for cognition moderates the impairment of decision making caused by nightshift work in nurses. Scientific Reports, 12, 1756.
Persico, N., Maltese, F., Ferrigno, C., Bablon, A., Marmillot, C., Papazian, L., et al. (2018). Influence of shift duration on cognitive performance of emergency physicians: A prospective cross-sectional study. Annals of Emergency Medicine, 72, 171–180.
Petru, R., Wittmann, M., Nowak, D., Birkholz, B., & Angerer, P. (2005). Effects of working permanent night shifts and two shifts on cognitive and psychomotor performance. International Archives of Occupational and Environmental Health, 78, 109–116.
Picano, E., Bruno, R. M., Ferrari, G. F., & Bonuccelli, U. (2014). Cognitive impairment and cardiovascular disease: So near, so far. International Journal of Cardiology, 175, 21–29.
Prasad, R. V., Gupta, S. L., & Swaminathan, S. (2021). Evaluation of cognitive and psychomotor functional changes in anesthesiology residents after 12 hours of continuous work in operation theater: An observational study. Anesthesia: Essays and Researches, 15, 362–367.
Proctor, S. P., White, R. F., Robins, T. G., Echeverria, D., & Rocskay, A. Z. (1996). Effect of overtime work on cognitive function in automotive workers. Scandinavian Journal of Work, Environment & Health, 22, 124–132.
Rouch, I., Wild, P., Ansiau, D., & Marquie, J.-C. (2005). Shiftwork experience, age and cognitive performance. Ergonomics, 48, 1282–1293.
Russell, B. A., Summers, M. J., Tranent, P. J., Palmer, M. A., Cooley, P. D., & Pedersen, S. J. (2016). A randomised control trial of the cognitive effects of working in a seated as opposed to a standing position in office workers. Ergonomics, 59, 737–744.
Salthouse, T. A. (2006). Mental exercise and mental aging: Evaluating the validity of the "use it or lose it" hypothesis. Perspectives on Psychological Science, 1, 68–87.
Schooler, C. (1984). Psychological effects of complex environments during the life span: A review and theory. Intelligence, 8, 259–281.
Schooler, C., Mulatu, M. S., & Oates, G. (1999). The continuing effects of substantively complex work on the intellectual functioning of older workers. Psychology and Aging, 14, 483–506.
Shwetha, B., & Sudhakar, H. (2012). Influence of shift work on cognitive performance in male business process outsourcing employees. Indian Journal of Occupational and Environmental Medicine, 16, 114–118.
Shwetha, B. L., & Sudhakar, H. H. (2014). Learning, memory & executive function in female BPO employees exposed to regular shifts. National Journal of Physiology, Pharmacy and Pharmacology, 4, 20–24.
Smith, L., Spelten, E., & Folkard, S. (1995). Shiftwork effects in nuclear power workers: A field study using portable computers. Work & Stress, 9, 235–244.
Soares, C. S., & de Almondes, K. M. (2017). Sleep quality and visuospatial performance in rotating shifts workers from a petrochemical company. Biological Rhythm Research, 48, 403–415.
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448–460.
Stern, Y., Alexander, G. E., Prohovnik, I., Stricks, L., Link, B., Lennon, M. C., et al. (1995). Relationship between lifetime occupation and parietal flow: Implications for a reserve against Alzheimer's disease pathology. Neurology, 45, 55–60.
Stout, J. W., Beidel, D. C., Brush, D., & Bowers, C. (2021). Sleep disturbance and cognitive functioning among firefighters. Journal of Health Psychology, 26, 2248–2259.
Sun, J., Stewart, P., Chiew, A., Becker, T., Siu, W., Varndell, W., et al. (2021). Association between shift work and cognitive performance on the trail making test in emergency department health officers. Emergency Medicine Australasia, 33, 711–717.
Taylor, Y., Merat, N., & Jamson, S. (2019). The effects of fatigue on cognitive performance in police officers and staff during a forward rotating shift pattern. Safety and Health at Work, 10, 67–74.
Titova, O. E., Lindberg, E., Elmståhl, S., Lind, L., Schiöth, H. B., & Benedict, C. (2016). Association between shift work history and performance on the trail making test in middle-aged and elderly humans: The EpiHealth study. Neurobiology of Aging, 45, 23–29.
Vajravelu, H. R., Krishnan, P., Ayyavoo, S., & Narayanan, K. (2016). Evaluation of cognition using neurophysiological and neuropsychological tests in rotating night shift workers: A pilot study. National Journal of Physiology, Pharmacy and Pharmacology, 6, 146–149.
Van Der Linden, D., Keijsers, G. P. J., Eling, P., & Van Schaijk, R. (2005). Work stress and attentional difficulties: An initial study on burnout and cognitive failures. Work & Stress, 19, 23–36.
Veddeng, A., Husby, T., Engelsen, I. B., Kent, A., & Flaatten, H. (2014). Impact of night shifts on laparoscopic skills and cognitive function among gynecologists. Acta Obstetricia et Gynecologica Scandinavica, 93, 1255–1261.
Vendramin, P., Valenduc, G., Molinié, A.-F., Volkoff, S., Ajzen, M., & Leonard, E. (2012). Sustainable work and the ageing workforce. European Foundation for the Improvement of Living and Working Conditions.
Virtanen, M., Singh-Manoux, A., Ferrie, J. E., Gimeno, D., Marmot, M. G., Elovainio, M., et al. (2009). Long working hours and cognitive function: The Whitehall II study. American Journal of Epidemiology, 169, 596–605.
Vuori, M., Akila, R., Kalakoski, V., Pentti, J., Kivimäki, M., Vahtera, J., et al. (2014). Association between exposure to work stressors and cognitive performance. Journal of Occupational and Environmental Medicine, 56, 354–360.
Wagner-Hartl, V., Grossi, N. R., & Kallus, K. W. (2018). Impact of age and hearing impairment on work performance during long working hours. International Journal of Environmental Research and Public Health, 15, 98.
Wang, Z., Chen, W.-H., Li, S.-X., He, Z.-M., Zhu, W.-L., Ji, Y.-B., et al. (2021). Gut microbiota modulates the inflammatory response and cognitive impairment induced by sleep deprivation. Molecular Psychiatry, 26, 6277–6292.
Zhao, X.-C., Han, K.-Y., Gao, Y.-Y., Li, N., Wang, L., Yu, L.-L., et al. (2021). Effects of shift work on sleep and cognitive function among male miners. Psychiatry Research, 297, 113716.
Zhuo, L.-B., Pei, J.-J., Yan, Z., Yao, W., Hao, C.-F., & Wang, H.-X. (2021). Working life job strain status and cognitive aging in Europe: A 12-year follow-up study. Journal of Affective Disorders, 295, 1177–1183.

Jonathan H. Westover, PhD is Chief Research Officer (Nexus Institute for Work and AI); Associate Dean and Director of HR Academic Programs (WGU); Professor, Organizational Leadership (UVU); OD/HR/Leadership Consultant (Human Capital Innovations). Read Jonathan Westover's executive profile here.

Suggested Citation: Westover, J. H. (2026). Work-Related Factors and Cognitive Health: Evidence-Based Insights for Organizational Practice. Human Capital Leadership Review, 30(4). doi.org/10.70175/hclreview.2020.30.4.4