Alzheimer's disease mortality among taxi and ambulance drivers (2024)

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.

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.

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.

https://en.wikipedia.org/wiki/Method_of_loci

I immediately go to these two thoughts:

- 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.

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.

Would love to see a study looking at people who spend significant time in video games that require spatial navigation.

That could even be a form of therapy after diagnosis (which seems to become easier with biomarkers).

So why not bus drivers? Supposedly because their routes are fixed?

I assume that was a generation that didn’t use Google Maps.

related - Indian food contains turmeric (curcumin) and indians don't get alzheimer's as much.

Would be interesting to see whether spatial reasoning from gaming shows the same association.

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.

That's a pretty positive spin on this statistic that ambulance drivers and taxi drivers die much younger than many other professions

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