[hereme888]

Wrong. Physicians (which includes pediatricians), who are in general less likely to get dementia, experience its signs at an older age in general due to protective effects of their high education. Among physicians, pediatricians seemed to have higher rates.

The discussion is very low-yield though, since infections are already a minor point re: dementia, and none of the evidence is conclusive.

[sarchertech]

That’s not what that sentence says though.

>Among physicians, pediatricians seemed to have higher rates.

Not just pediatricians, but physicians that work at hospitals and clinics.

Which is nearly all of them.

I think what you’re dealing with is a low quality, low effort survey study from Taiwan, which was poorly written, so there is no point trying to figure out what they meant.

[hereme888]

It's not a strong study, and the demographic group was very particular, but it involved 30k physicians, which is something. I would have no problem conceding that I misread the study, but ChatGPT, which is obviously never wrong (joking of course), agreed with me: https://chatgpt.com/share/6a550f00-d174-83ea-b111-0369a8e4db...

[sarchertech]

I was wrong calling it a survey study, because I didn’t realize Taiwan had such detailed information on every citizen.

But looking at the specific data the naive ratio for pediatricians is lower than several other specialities. It was only higher when they adjusted for confounding factors. But the list of confounders was limited by the data available.

In addition they found that for some reason working at a large hospital was protective, but they didn’t adjust for hospital size when comparing specialities. In general pediatricians are less likely to work at large hospitals than the average specialty (wife is a pediatrician).

The result is essentially a cherry picked result that only adjust for some confounders. Add to that only 19 cases of dementia among pediatricians. Then the CI for pedestrians overlaps every other listed speciality. The study is essentially meaningless for your purposes.

Also the paper is actually saying that older doctors are more likely to have dementia than younger doctors, not that doctors develop dementia later than the general population.

[hereme888]

Let me try to paint a picture:

Academic and ongoing challenging education results in greater number of connections between nerves. In normal population, as plaque accumulates, it causes loss of transmission and deterioration of nerve connections.

In physicians, because they have more "density" and more pathways in which nerves are connected than the general population, dementias like Alzheimer's show no symptoms until there's even more plaque accumulated, because they can compensate with extra pathways, similar to the study on nuns who showed no signs of alzheimer's at an old age because they kept so active, even though post-mortem they had horrible alzheimer's on biopsy. At the late stage physicians finally manifest the dementia, it's stronger and progresses quicker. It's like "catching it late" for doctors.

[sarchertech]

That’s possible (although the plaque hypothesis as the sole cause is looking less plausible).

But that’s not what the study is saying. It’s literally just saying that older doctors are more likely than younger doctors to have dementia.

Also that study only looks at dementia and Alzheimer’s only accounts for ~2/3 of cases.

[hereme888]

Plaque is the end-cause. What's debatable is why it accumulates and what pharmaceuticals and interventions we doctors should prescribe for our patients, not whether it's present or not.