[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.

[alfiedotwtf]

Isn't cholesterol released into the bloodstream to protect arteries when it gets acidic, and over time turning into plaque buildup? Also, going the other way doesn't help either because if you got a spike in acid your arteries wouldn't cope with the overload

[hereme888]

I'm not sure what you're referring to re: Alzheimer's plaque. They're not the same type of "plaque". Alzheimer's is basically little pieces of protein that clumped together and the body couldn't get rid of it. Generally, pH changes can affect proteins and lead to their clumping, but that's not the mechanism here. It's when there's too much of these abnormal proteins that normally get filtered away. It's generally called "amyloidosis". There's many theories for why: some think it's linked to bacteria from our mouths getting into the brain, some think it's because the glymphatic system got clogged (healthy flow of CSF fluid, like clogging of certain holes where it's supposed to flow more freely, etc, etc). Not the same substance as arterial plaque.