Aug. 9, 2004 -- Got a mind-draining job? It might protect you from Alzheimer's disease, a new study suggests.
The causes of dementia and Alzheimer's disease are still being scrutinized. Scientists know that genetics account for only a part of the 4.5 million Alzheimer's disease patients in the U.S. But they have difficulty teasing out the impact of such factors as education, diet, and socioeconomic status -- including occupation.
Several studies have found that blue-collar workers develop more cases of dementia and Alzheimer's disease in their later years. But why?
This current study delves more deeply into occupation to understand the specific job demands that make the difference, lead researcher Kathleen Smyth, PhD, a sociologist at Case Western Reserve University and University Hospitals of Cleveland, tells WebMD.
Her study, which appears in the current issue of the journal Neurology, involved a group of people over age 60. Through extensive testing, 122 patients were diagnosed as having signs of Alzheimer's disease. The 235 people in the comparison group were the patients' friends and neighbors whose tests showed no signs of Alzheimer's.
Family members provided information about jobs the Alzheimer's patients held. The comparison group provided similar job history details.
Researchers then sifted through thousands of Department of Labor job descriptions. That helped them identify factors like job complexity, training required, aptitude required, whether activities required abstract, creative abilities vs. routine and concrete ones, physical demands, and work conditions.
Early Signs of Dementia?
The Alzheimer's patients had held mostly blue-collar jobs. However, another pattern emerged.
"When both groups were in their 20s, there were few differences in the mental demands of their jobs," Smyth tells WebMD. "But in their 30s, 40s, and 50s, we did find differences -- increased mental demands among [the comparison group]. For those with Alzheimer's disease, the mental demands from their jobs stayed flat ... they did not advance."
In those early years, something had changed. "We don't know exactly what," says Smyth.
One theory: Even as early as their teens or 20s, "Alzheimer's may have been affecting them in some subtle way, keeping them from moving into more advanced jobs," Smyth tells WebMD. "Many researchers feel that a big piece of dementia is 'brought to the table' at a very early age."
Another theory: "Life circumstances kept them from getting more advanced jobs," she says. "They didn't get the right opportunities and got stuck in low-level jobs. It's use it or lose it. Over three decades, if you're not mentally stimulating yourself, it's not good for your brain."
"We're hoping this is the take-home message -- build variety into your job," Smyth says. "Choose jobs where you have variety. And if you have a job that is routine, compensate in other ways. Studies looking at leisure activities show they have an impact. There's pretty wide acceptance that trying to keep your mind active is what's important."
A Second Opinion
"All these Alzheimer's studies have a fundamental problem that is tough to overcome -- that people are very complex, and success in your career is much more than book smarts and educational achievement," James Lah, MD, PhD, a clinical neurologist and neuroscientist at Emory University School of Medicine in Atlanta, tells WebMD. Lah agreed to provide insights on Smyth's study.
Indeed, the development of Alzheimer's may start much earlier than once thought. Or another contributing factor may be in place, like a developmental problem, he says.
Lah points to a famous study of 30 nuns from the order of the School Sisters of Notre Dame who provided blood samples and underwent testing of their mental abilities from their 70s until their deaths. The nuns also gave permission to be autopsied after death. The findings have helped provide answers to the puzzle of Alzheimer's disease.
Researchers analyzed essays the nuns wrote 50 to 60 years earlier, when they were novitiates in their teens or early 20s. "Their writing indicated their linguistic abilities, a measure of intelligence. But their writing -- whether it was complex or not -- also showed subtle signs of Alzheimer's disease," Lah tells WebMD. "It could be that something was going on in their brains that affected their writing, that also played a role in their developing Alzheimer's disease later on."
Nevertheless, he continues counseling patients to do crossword puzzles and to continue interpersonal interactions, to keep their brains in good operating condition. "It's something a lot of us would like to believe is true -- that we can actively prevent dementia. We don't know for sure it's going to help, but we know for sure it's not going to hurt."
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