Cognitive decline is an issue gaining prominence in the workforce as more and more baby boomers delay retirement due to tougher economic conditions.

And rightly so. In Australia, in the next 40 years, the number of adults aged 64–84 is expected to more than double, while the number of young people will shrink drastically. Moreover, the number of adults with dementia will rise to an estimated 943,000 by 2050, with approximately 5 per cent of the Australian population having dementia by the time they are 65.

These projections are a wake-up call for employers to be mindful that, while an employee may have been promoted to a level of capacity, their capacity may diminish over time.

The many causes of dementia, or irreversible cognitive deterioration, include traumatic brain injury, alcohol, AIDS and drugs. But the most common form is Alzheimer’s, which has an initial phase where cognitive difficulties are present but not severe. Some people have cognitive difficulties for at least 15 years before diagnosis.

HR practitioners need to be aware that, with this increasingly common, hidden health time bomb, cognitive problems may be creating difficulties in their workforce at earlier ages than anticipated. Employees may remain in their roles with cognitive deficits that interfere with work capacity and productivity, and this may also have significant implications for work health safety.

Early cognitive changes and dementia are major sources of disability, and there is no cure. The global economic cost of dementia care is currently estimated at $315 billion, and rising rapidly.

Dementia: HR implications

The reality is that some workers will get dementia and others will need to take leave to care for them. Dementia is indiscriminate, impacting on individuals from all socioeconomic and employment levels, but always affecting productivity and presenting significant work health and safety issues.

An employee who starts to forget safety protocols puts at risk their own safety and that of others. A financial operating officer may be unable to make sound decisions, risking the financial security of the company. A lawyer may give poor legal advice resulting in a lawsuit, or a person in administration may be unable to efficiently complete tasks.

Research indicates that job type and workplace conditions are significant factors in how cognitive decline plays out (especially when it comes to the negative impact on employment participation). With this in mind, workplace practices need to adapt to facilitate longer working lives and health of older people, as well as to maintain OHS/WHS.

Referral guidelines

Early identification of cognitive decline is crucial for work health and safety, and assessment is vital for early intervention. Reflecting this, the federal government’s National Health Priority mandate of June 2013 states that early intervention is necessary “to enhance productive ageing”. Early intervention may also promote employment capacity, with research suggesting engagement and a healthy lifestyle can slow progression of the disease.

Diagnosis of a neurocognitive disorder can only be made by registered medical practitioners, psychiatrists, neurologists, geriatricians and clinical neuropsychologists. However, employers and HR practitioners have a significant role in identifying individuals with cognitive difficulties in the workplace.

The main feature is deterioration, with an employee losing ability to perform duties with the same degree of accuracy, efficiency and timeliness as previously. Keep in mind that cognitive decline can occur before the age of 65; younger workers may also be at risk.

Signs to look out for

• Forgetting and trouble remembering tasks, instructions and appointments.
• Limited learning and difficulty learning new material and role requirements.
• An unawareness of making mistakes or having difficulties.
• Disorientation. Becoming ‘lost’, or losing track of where they are or what they are doing.
• Poor attention and lapses of concentration.
• Avoiding responsibility, delegating work, recruiting help, requesting more time or input to complete work.
• Anxiety, feeling overwhelmed, or stressed by task and role requirements.
• Difficulties in word selection and poor verbal fluency.

Means of response

If you spot potential cognitive decline in an employee:

• Sensitively discuss the deterioration in work capacity with the employee, and encourage them to see a medical practitioner.
• Arrange a neuropsychological assessment, which can be performed only by a registered psychologist.
• Once diagnosed, in consultation with the employee, look to revise duties that expose potential work health and safety issues.

This article is an edited version. The full article was first published in the December 2014/January 2015 issue of HRMonthly magazine as ‘Identifying dementia’. AHRI members receive HRMonthly 11 times per year as part of their membership. Find out more about AHRI membership here.