Comment by fn-mote
16 hours ago
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 while simultaneously telling your partner where to turn as you go.
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.
> Map books were no fun but some of the dudes I worked with definitely became route-finding savants.
Similar. I worked doing deliveries for an event company all over the greater NY area, based out of Queens. I usually rode jump-seat and spent a few years with a retired trucker who was such a savant. He could maneuver a truck through any tight/precarious situation with great precision and care. He could visit a location once and recall it next year, every year.
The most impressive was a full day gauntlet starting at 5 AM where he navigated starting in south queens NYC to a stop in Staten Island, then off to Jersey city, then up to Sleepy Hollow NY, then all the way to some Greek church deep in Suffolk county through the winding maze that is the north shore - no map, no gps.
The most scary situation was driving a smaller Isuzu cab-over box truck through Brooklyn on a hot summer day. We had no AC, windows down, headed along a narrow avenue under the elevated train tracks. A passing truck was a little too far - BOOM- a loud shattering glass and bang sound. Turns out that idiot hit his mirror violently into ours so hard it showered him directly in the face with shards of mirror. I only got hit with a few pieces in the arm and a bunch landed on my lap. He didn't flinch. He kept the truck strait while muttering "I've been waiting for that to happen again." He thankfully only had two small cuts on his face, nothing went into his eyes. We lucky passed an auto parts store and he was able to rig up something on the mirror bar, continued on and finished the route.
He was a real character and he always had a lot of fun and crazy road stories. That dude also taught me to drive a truck with air brakes which is also how I learned to drive a manual. In addition to showing me all the secret traffic avoidance and toll beating routes, he was a foodie and showed me a lot of interesting restaurants he'd stop at along our routes. He took me to the famous Wo Hop in Manhttan's China Town when you could just walk in and get a table (late 90's.) He parked the truck at an inactive construction site a block away and moved cones around it so we didn't get a ticket. That character knew all the tricks :-)
In a similar vein, to drive a black taxi in London you have to pass The Knowledge of London exam which requires becoming a human routing database for over twenty thousand streets and landmarks.
Yep, if you see someone on a scooter with a clipboard attached to the handlebars it's quite likely to be someone studying for The Knowledge.
I know this from the "Up" series [1] from the late Michael Apted.
Tony got his "knowledge" around "21-Up" in the series, became a London cabby by "28-Up" [2].
[1] https://en.wikipedia.org/wiki/Up_(film_series)
[2] https://youtu.be/_rQ1V7m0Kfs?t=142
The Knowledge is exactly the first thing to get into my mind the moment I read the headline.
Made me think of this as well.
If I remember the story I read correctly, they just call it "The Knowledge". What a great name.
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This is such a great anecdote, thanks for sharing!
>> 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.
Amazing. Paper-based GPS before actual GPS was a thing.
And they are called maps. Wonderful stuff.
Wait till you see the Honda Electro Gyrocator:
https://en.wikipedia.org/wiki/Electro_Gyrocator
A causal link is easy to imagine. An Alzheimer's onset makes one unfit to work as an ambulance driver, they switch to a less demanding job. When, years later, the person dies, the death is not counted towards ambulance drivers.
> death certificates included a field for reported usual occupation (the occupation in which the decedent spent most of their working life), generally completed by a funeral director with help from the decedent’s informant
Will we see a drop in alzheimers when the open world gaming population reaches that age? I mean, I can not just navigate my city, but multiple worlds!
And/or will we see an increase in Alzheimer's disease amongst Google-Maps dependent users? Maybe we will see a bimodal split in both directions.
Yeah, basically Waze is causing dementia
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I’m not sure because in many modern open world games you are just like a Uber driver following GPS from checkpoint to checkpoint. It would with old school games that relied on memorizing the world and had minimal or even no map indications.
I feel like a dark souls game has a similar learning pattern where you need to memorize the move sets of bosses. It taps into that dynamic pattern recognition that traffic would cause for taxi drivers
DayZ is another one because there is no in-game GPS. You have to use maps and compasses to figure your route and many people can spot an exact area on the massive map by a picture of a bush
There's a paper on it:
"Video gaming, but not reliance on GPS, is associated with spatial navigation" paper shows there was a significant association between self-reported weekly hours of video gaming and wayfinding performance.
https://www.sciencedirect.com/science/article/pii/S027249442...
Tested with Sea Hero Quest
With the open world™ minimap and objective markers on the corner of the screen? I suspect not :)
even with one functioning eye! because you're used to navigate by looking at a 2d projection on a screen
The main question that comes up when I see a study like this is if they were able to take the same hypothesis and replicate it on another dataset in a different locale. For instance, presumably you could run the same study on UK data. Would we see the same results?
This kind of replication would make the findings much more convincing.
What are some possibilities?
Any others? One consideration is that those with jobs requiring long periods of concentration drink less. Among other things.
I'm sure that the study accounted for this, but some fun ones
1. Ambo and Taxi drivers are vastly more likely than the general population to die in a collision before Alzheimers gets to them. 2. Even if you control out collisions, driving an Ambo and Taxi requires enough more memory and cognitive functioning to survive that people with early Alzheimer symptoms are significantly more likely to die in a collision, meaning you've controlled out a good chunk of ALzheimer victims in the process.
People with excess brain capacity are able to easily acquire spatial reasoning, and can (more) easily work/qualify for ambo and taxi jobs. Their excess brain capacity makes progressive brain damage more difficult to impact them before other causes of death.
- Drivers with early symptoms of Alzheimer’s struggled to remain effective and changed profession
I had the same thought, but occupation on the birth certificate is the "usual" occupation the person held.
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Ambulance drivers were close to medical professionals and got good, early diagnosis and care.
Taxi drivers were exposed to a wide variety of people who they conversed with, became aware of Alzheimer's symptoms and treatments and sought help early.
Off the top of my head.
It seems like you could get into roles with a duty of care, logistic and deadline planning, social contact, etc.
And try to control with so many other non-transport occupations like nurses, therapists, hairdressers, air-traffic controllers, etc.
Ironically, the transport aspect reminds me of a prior correlation I read about for truck drivers and higher rates of colon cancer. There were speculative theories as to whether it was from the hours sitting or something like the chronic vibration.
That would normally make sense, but Alzheimer's treatments don't significantly prolong life. You'd also expect to see the same effect with other medical professionals.
Pure speculation here. Driving is a sedentary occupation which might increase the percentage of deaths attributable to a sedentary lifestyle, with consequent decrease for Alzheimers?
It's about hippocampal size, so people with a larger hippocampus are less likely to get alzheimers as it's a barrier, lots of studies scanning London cabbies brains and they have enlarged hippocampus - it's believed to give a barrier against alzheimers.
So spatial navigational ability is another risk factor/biomarker (along with blood pressure, smoking etc)
Social interaction while spatially reasoning also helps. (Social + cognitive load)
I haven't read the article, but what if:
The problems arrizing from alzheimers are so problematic, that the cabdrivers / ambulance drivers drive themselves to death before they enter the stats as alzheimers patients?
A bit like the famous bullet holes in planes from ww2
Both are also very social occupations, talking with multiple strangers every day.
Except causation, what can the connection be? Some genes causing both spatial reasoning and suppressing Alz?
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.
But that's not a spatial reasoning connection. Also would include all other drivers.
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