Alzheimer’s disease mortality among taxi and ambulance drivers: population based cross sectional study

BMJ 2024; 387 doi: https://doi.org/10.1136/bmj-2024-082194 (Published 17 December 2024)

Abstract

Objective To analyze mortality attributed to Alzheimer’s disease among taxi drivers and ambulance drivers, occupations that demand frequent spatial and navigational processing, compared with other occupations.

Design Population based cross-sectional study.

Setting Use of death certificates from the National Vital Statistics System in the United States, which were linked to occupation, 1 January 2020-31 December 2022.

Participants Deceased adults aged 18 years and older.

Main outcomes measures Among 443 occupations studied, percentage of deaths attributed to Alzheimer’s disease for taxi drivers and ambulance drivers and each of the remaining 441 occupations, adjusting for age at death and other sociodemographic factors.

Results Of 8 972 221 people who had died with occupational information, 3.88% (348 328) had Alzheimer’s disease listed as a cause of death. Among taxi drivers, 1.03% (171/16 658) died from Alzheimer’s disease, while among ambulance drivers, the rate was 0.74% (10/1348). After adjustment, ambulance drivers (0.91% (95% confidence interval 0.35% to 1.48%)) and taxi drivers (1.03% (0.87% to 1.18%)) had the lowest proportion of deaths due to Alzheimer’s disease of all occupations examined. This trend was not observed in other transportation related jobs that are less reliant on real time spatial and navigational processing or for other types of dementia. Results were consistent whether Alzheimer’s disease was recorded as an underlying or contributing cause of death.

Conclusions Taxi drivers and ambulance drivers, occupations involving frequent navigational and spatial processing, had the lowest proportions of deaths attributed to Alzheimer’s disease of all occupations.