The rate of fatality for Alzheimer’s among ambulance and taxi drivers is 3x lower than the general population. This is not observed in other transportation-related careers.
The connection is believed to be the spatial reasoning involved in routing. No causative link is suggested.
> The connection is believed to be the spatial reasoning involved in routing.
This is triggering me lol. I was a Paramedic for 10 years and 3 of those years were before GPS existed and we had these awful 900 page 5" thick things we had to wield on the fly called Map Books. It was part of our probation period testing and they would time us to pick out the routes reliably within a certain deadline or not graduate from being a probie.
While your partner drove to the call you'd put the book on your lap and flip to the big large grid which would tell you which map your location would be on (page 770), then you'd look up the street in the back appendix to get the coordinates for the specific house (P5, C2) and then find the cross street on another page (P5, C3), go to the grid and find the closest appropriate hospital for the purpose of the call (different ERs have different functions- for gunshots go to Highland, for amputations go to CalPac Davies, for heart attacks go to UCSF, etc) (page 815), the street location for that (A6, C4) and then make your route while flipping back and forth between all the pages.
When I went to a better ran company, dispatch would give us map page and grid coordinates over the radio when we got the call.
Within a few months you learn most of the neighborhoods and routes, and road hazards and preferences- for example if going to UCSF from the Peninsula take O'Shaughnessy because there's no traffic and is a smooth ride. And if you're going to Seton Hospital from 101 slow down around the turn on the on ramp onto 280 because there is a GIANT bump that will knock your partner in the back's head into the ceiling and not be comfortable for the patient on the gurney.
Map books were no fun but some of the dudes I worked with definitely became route-finding savants.
1. Those with spatial reasoning are less likely to develop Alzheimers
2. Ambo and Taxi drivers are less likely (for some reason) to develop Alzheimers AND their work leads them to develop good spatial reasoning.
Any others? One consideration is that those with jobs requiring long periods of concentration drink less. Among other things.
The taxi-driving Alz patients may overwhelmingly die of something that leads to physicians not listing Alz as a cause of death. If taxi driving is loaded in such a way that Alz presents significant challenges (eg loss of income), that could be the case.
One easy way to confirm this is to look at the impact of GPS on this + whether London taxi drivers get less frequent Alzheimer’s than other cities/countries that don’t have the same requirements and complexities.
I would imagine the combo of spatial reasoning and mapping plus social stimulation could be a reason. You could also argue both are regularly training reflexes and fine motor movement.
Or could be there some weird variable that's unaccounted for ? Do taxi drivers and ambulance drivers for some reason have more regular sleep patterns ? We know that is definitely helpful for Alzheimer's
One of the first signs that a somebody has Alzheimer's is that they'll get lost. E.g., they've been attending church on Thursdays nights at the same chapel for 15 years, but suddenly they forgot how to get home after a recent service. Part of the reason for the findings in the current study is that people quit those professions when they feel themselves starting to struggle.
Is the profession cached in the data when they leave the job? And does the data attribute 2 entries for someone with 2 careers. That’s the question I think
They explain it in the article. Someone, often the funeral director filling out the death certificate, asks what the deceased did for most of their working life.
I’m a little skeptical of the category “ambulance drivers; not emergency medical technicians” as reliably coded, because people will often say so-and-so “drove an ambulance” when they were actually an EMT or paramedic. But it’s also not clear to me that would invalidate the findings.
It seems a lot of people already know that. I remember their's a claim that Taxi drivers hipocampus is larger than average people. A memory method called "Memory palace" or "Method of Loci" exists for 2 thousand years exploiting human's navigation capability.
- Is significant life-long usage of real-time mental spatial navigation protective?
- Are those who end up in these positions self-selected for better than average real-time mental spatial navigation and that above average performance correlates with protection against Alzheimer's.
Anecdotal, but I've spoken with many taxi and ride-share drivers, and my impression is that their decision to seek out and continue that line of work is almost always driven by outside economic considerations. I've never heard someone base their decision on their ability to perform the job.
Exactly - I'm thinking the bad spatial navigators have a higher probability of washing out of driving and pursue some other career. They may not say "I'm bad at figuring out where I am", but the economics of the job are just a little bit worse for these people.
I was really expecting this to be higher not lower due to factors like particulate inhalation from exhaust/brake dust/tire particles. Also there's a lot of sedentary-type problems you get while taxi driving like bad diet habits that are not conducive to brain health.
Dunno, did taxi driving for a few years. Mostly suburban for a small fleet, not gigging. I'm thinking newer drivers that rely on smartphones for navigation won't get the same benefit.
I seem to recall that at least some populations of taxi driver they have exams like The Knowledge (https://london-taxi.co.uk/the-knowledge/) where changes in structures of the brain can be measured after learning it.
I was thinking the same thing, about the tire particles and sedentary problems. It's really true the what you do for your daily work over many years shapes your body.
At my most recent EMS job ("ambulance driver" is considered insulting), the younger people couldn't navigate anywhere without mapping it. Some of them brought up being amazed that I could get to every hospital in our area from pretty much anywhere without having to bring it up on my phone (random houses and nursing homes were a different story).
This is indeed interesting because rotating 2D screen is not necessarily the same type of brain processing as experiencing things fly around you. Even VR is not necessarily the same, because knowing you're safe may be different from taking the situation seriously. Could be same, could be completely different.
But the first massively popular 3D games started end of 90s which means Alzheimer cases for them will pop up only around 2060 or later (average onset year 75 minus being 15 years kid during 90s).
My first reaction to the title was: "duh, selection/survivorship bias" but their counter is pretty solid:
> Firstly and perhaps most importantly, selection bias is possible because individuals who are at higher risk of developing Alzheimer’s disease may be less likely to enter or remain in memory intensive driving occupations such as taxi and ambulance driving. This could mean that the lower Alzheimer’s disease mortality observed in these occupations is not due to the protective effect of the job itself but rather because those prone to the disease may have self-selected out of such roles. However, Alzheimer’s disease symptoms typically develop after patients’ working years, with only 5-10% of cases occurring in people younger than 65 years (early onset).1114 While subtle symptoms could develop earlier, they would still most likely be after a person had worked long enough to deem the occupation to be a so-called usual occupation, suggesting against substantial attrition from navigational jobs due to development of Alzheimer’s disease. Moreover, even if lifelong taxi driving selects for individuals with strong spatial processing, our findings would still suggest an interesting link between spatial processing skills and risk of Alzheimer’s disease.
The connection is believed to be the spatial reasoning involved in routing. No causative link is suggested.
This is triggering me lol. I was a Paramedic for 10 years and 3 of those years were before GPS existed and we had these awful 900 page 5" thick things we had to wield on the fly called Map Books. It was part of our probation period testing and they would time us to pick out the routes reliably within a certain deadline or not graduate from being a probie.
While your partner drove to the call you'd put the book on your lap and flip to the big large grid which would tell you which map your location would be on (page 770), then you'd look up the street in the back appendix to get the coordinates for the specific house (P5, C2) and then find the cross street on another page (P5, C3), go to the grid and find the closest appropriate hospital for the purpose of the call (different ERs have different functions- for gunshots go to Highland, for amputations go to CalPac Davies, for heart attacks go to UCSF, etc) (page 815), the street location for that (A6, C4) and then make your route while flipping back and forth between all the pages.
When I went to a better ran company, dispatch would give us map page and grid coordinates over the radio when we got the call.
Within a few months you learn most of the neighborhoods and routes, and road hazards and preferences- for example if going to UCSF from the Peninsula take O'Shaughnessy because there's no traffic and is a smooth ride. And if you're going to Seton Hospital from 101 slow down around the turn on the on ramp onto 280 because there is a GIANT bump that will knock your partner in the back's head into the ceiling and not be comfortable for the patient on the gurney.
Map books were no fun but some of the dudes I worked with definitely became route-finding savants.
>> for gunshots go to Highland, for amputations go to CalPac Davies, for heart attacks go to UCSF, etc
Oooft. My utmost respect. I could not do this job.
Or could be there some weird variable that's unaccounted for ? Do taxi drivers and ambulance drivers for some reason have more regular sleep patterns ? We know that is definitely helpful for Alzheimer's
I’m a little skeptical of the category “ambulance drivers; not emergency medical technicians” as reliably coded, because people will often say so-and-so “drove an ambulance” when they were actually an EMT or paramedic. But it’s also not clear to me that would invalidate the findings.
https://en.wikipedia.org/wiki/Method_of_loci
- Is significant life-long usage of real-time mental spatial navigation protective?
- Are those who end up in these positions self-selected for better than average real-time mental spatial navigation and that above average performance correlates with protection against Alzheimer's.
Anecdotal, but I've spoken with many taxi and ride-share drivers, and my impression is that their decision to seek out and continue that line of work is almost always driven by outside economic considerations. I've never heard someone base their decision on their ability to perform the job.
That they’re consciously aware of
Dunno, did taxi driving for a few years. Mostly suburban for a small fleet, not gigging. I'm thinking newer drivers that rely on smartphones for navigation won't get the same benefit.
I seem to recall that at least some populations of taxi driver they have exams like The Knowledge (https://london-taxi.co.uk/the-knowledge/) where changes in structures of the brain can be measured after learning it.
That could even be a form of therapy after diagnosis (which seems to become easier with biomarkers).
But the first massively popular 3D games started end of 90s which means Alzheimer cases for them will pop up only around 2060 or later (average onset year 75 minus being 15 years kid during 90s).
> Firstly and perhaps most importantly, selection bias is possible because individuals who are at higher risk of developing Alzheimer’s disease may be less likely to enter or remain in memory intensive driving occupations such as taxi and ambulance driving. This could mean that the lower Alzheimer’s disease mortality observed in these occupations is not due to the protective effect of the job itself but rather because those prone to the disease may have self-selected out of such roles. However, Alzheimer’s disease symptoms typically develop after patients’ working years, with only 5-10% of cases occurring in people younger than 65 years (early onset).1114 While subtle symptoms could develop earlier, they would still most likely be after a person had worked long enough to deem the occupation to be a so-called usual occupation, suggesting against substantial attrition from navigational jobs due to development of Alzheimer’s disease. Moreover, even if lifelong taxi driving selects for individuals with strong spatial processing, our findings would still suggest an interesting link between spatial processing skills and risk of Alzheimer’s disease.