Taxi drivers offer a clue to Alzheimer's risk

<a href="https:&#x2F;&#x2F;archive.ph&#x2F;9oqkn" rel="nofollow">https:&#x2F;&#x2F;archive.ph&#x2F;9oqkn</a>

A study came out in 2000, back when I was driving a taxi, showing that London cabbies with &quot;the Knowledge&quot; had changes to their brain anatomy.[0]<p>My girlfriend at the time spotted it in a college course and showed it to me. I remember her joking that she was only with me for the size of my hippocampus.<p>I would hypothesize that it&#x27;s more related to spacial&#x2F;geographic memory than simply navigating spaces one visually perceives. My guess is the effect would be much less pronounced in people who drive for a living now relying on GPS maps.<p>London taxi drivers, apparently, still must pass the notoriously difficult Knowledge test.[1] A similar (but less rigorous) test was required for Los Angeles cab drivers when I drove. And of course, if you weren&#x27;t familiar with the street where your next call was (or where your passenger wanted to go), you had only seconds at a red light to leaf through the enormous Thomas Guide and memorize how you would get there.[2]<p>[0] <a href="https:&#x2F;&#x2F;www.pnas.org&#x2F;doi&#x2F;full&#x2F;10.1073&#x2F;pnas.070039597" rel="nofollow">https:&#x2F;&#x2F;www.pnas.org&#x2F;doi&#x2F;full&#x2F;10.1073&#x2F;pnas.070039597</a><p>[1] <a href="https:&#x2F;&#x2F;london-taxi.co.uk&#x2F;the-knowledge&#x2F;" rel="nofollow">https:&#x2F;&#x2F;london-taxi.co.uk&#x2F;the-knowledge&#x2F;</a><p>[2] <a href="https:&#x2F;&#x2F;archive.org&#x2F;details&#x2F;losangelescounty0000thom&#x2F;page&#x2F;n9&#x2F;mode&#x2F;2up" rel="nofollow">https:&#x2F;&#x2F;archive.org&#x2F;details&#x2F;losangelescounty0000thom&#x2F;page&#x2F;n9...</a>

Here&#x27;s a link to the actual study, which is very readable:<p><a href="https:&#x2F;&#x2F;www.bmj.com&#x2F;content&#x2F;387&#x2F;bmj-2024-082194" rel="nofollow">https:&#x2F;&#x2F;www.bmj.com&#x2F;content&#x2F;387&#x2F;bmj-2024-082194</a>

I wonder if this also applies to people that live urban environments that don&#x27;t drive and have to navigate walking or using the subway.<p>From my anecdotal evidence, it does seem that the average elderly person in NYC is way more active and social than an elderly person in the suburbs. But of course, it could be that people that live in cities self-select.

Does navigating spaghetti code count as well?

I do wonder though if its cause and effect are the wrong way.<p>Perhaps the type of person who can remember enough to get the job and be good at it is already less likely to get Alzheimers, and we just selected for those people.<p>I think this is not very likely though

Recently related:<p>Herpes virus and repeated head trauma linked to Alzheimer’s, study finds (2025) <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42629076">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42629076</a><p>Why Alzheimer&#x27;s Scientists Are Re-Thinking the Amyloid Hypothesis (2025) <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42628529">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42628529</a><p>Herpes Virus Might Drive Alzheimer&#x27;s Pathology, Study Suggests (2025) <a href="https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42578383">https:&#x2F;&#x2F;news.ycombinator.com&#x2F;item?id=42578383</a>

&gt; Taxi drivers may have a lower risk of developing Alzheimer’s because they are constantly using navigational and spatial processing.<p>It would be interesting to know whether certain kinds of video game play have a similar effect. On the one hand, you don’t do it for 8+ hours a day every day (unlike cab drivers), but on the other hand, there might be a much higher volume of spatial and navigational decisions packed per minute in certain games.

Am I interpreting the data correctly in that, whatever protective effect was found on Taxi drivers and Ambulance drivers, was actually aggravated on Ship Captains and Airline Pilots?<p>My immediate thought went to the negative effect of sleep quality and work schedules, but I would expect the same sleep strain&#x2F;stress for Ambulance drivers. A lot going on epidemiology wise but interesting study nevertheless.

This is basic &quot;mind palace&quot; theory, no? Human memory is linked to navigation; the more you associate memories with navigable places, the stronger your memories will remain.

This reporting feels a bit superficial, especially given the exciting direction Alzheimer’s research is taking.<p>It might sound unconventional, but what if taxi drivers, through constant exposure to small amounts of pathogens from travelers worldwide, experience enough immune imprinting to help prevent diseases like Alzheimer’s?<p>There’s an intriguing study suggesting that one type of Alzheimer’s might be linked to a chronic gut infection that eventually makes its way to the brain.<p><a href="https:&#x2F;&#x2F;news.asu.edu&#x2F;20241219-health-and-medicine-surprising-role-gut-infection-alzheimers-disease" rel="nofollow">https:&#x2F;&#x2F;news.asu.edu&#x2F;20241219-health-and-medicine-surprising...</a><p>We are likely on the verge of a scientific revolution that will redefine viruses as key drivers behind some of the most devastating diseases known to humanity.

When I read these headlines I wonder &quot;Causation? Correlation?&quot;. Maybe it&#x27;s addressed in the study but.....<p>Is it that navigating with you brain is good to prevent Alzheimers? Or are you just more likely to die from something else as a cabbie. Statically speaking your more likely to die, than average, from a traffic related accident. Maybe the all the fumes cause something else terrible that kills you, etc.<p>It does seem logical to me that using your brain more could help offset these dementia related diseases. But it also seems like if that made a huge difference, we&#x27;d see statistically vastly more alzheimers in &quot;low thought&quot; jobs like retail cashiers and people who don&#x27;t work&#x2F;retire early vs say... collegiate professors.

&gt; <i>Taxi drivers may have a lower risk of developing Alzheimer’s because they are constantly using navigational and spatial processing.</i><p>A good reason to not use GPS&#x2F;GNSS apps too much.<p>Unless it&#x27;s going to a location that&#x27;s completely unfamiliar, I try to only check for red zones before I leave, and then use my familiarity of my city to get to my destination: know my starting point, know a major intersection near the destination, and avoid known-bad locations in between. If I get lost I can always pull out the app to re-orient.

A whole generation now uses navigation, is the prediction that there will be an increase in Alzheimer’s in this new generation due to reduced navigational processing?

Not sure how that compares to era where most people didn’t use google maps, but if you use google maps, you are using some part of your brain less especially memorizing or trying to reverse a route from memory. Or that if you can’t remember very well, you wouldn’t last long as a taxi driver(survivor ship bias)

Did this study identify who had the APOE4 gene?<p>Another study <a href="https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41590-023-01627-6" rel="nofollow">https:&#x2F;&#x2F;www.nature.com&#x2F;articles&#x2F;s41590-023-01627-6</a> suggests the APOE4 gene may be preventing immune cells in the brain from switching to the defensive &quot;clean&quot; mode.<p>I know my mother&#x27;s hippocampus was smaller than something like 94% of people her age when she was diagnosed 11 years ago.<p>First signs of AD generally show up in the hippocampus.<p>Maybe with heavy spatial reasoning activity in that region, the AD mechanism is stunted or interfered with.<p>I would be curious to know what activities outside of vehicle navigation stimulate the hippocampus equally. I still play a lot of 3D video games.

I remember a study as well where folks who were much more religious also had a lower rate of Alzheimer&#x27;s. The purported cause was that remembering the hymns&#x2F;chanting verses forces your brain to be more supple and active, staving off whatever causes it. Will try find it and link later.

The study also shows that taxi drivers have very low lifespan, which of course is highly correlated to ower risk of death by Alzheimer&#x27;s. They also ignored may other professions with similar or lower Alzheimer&#x27;s risk.<p>Overall, it feels suspicious that they ignored other potential explanations for the data.

Does anyone know how to download the data for the charts in the study?<p><a href="https:&#x2F;&#x2F;www.bmj.com&#x2F;content&#x2F;387&#x2F;bmj-2024-082194" rel="nofollow">https:&#x2F;&#x2F;www.bmj.com&#x2F;content&#x2F;387&#x2F;bmj-2024-082194</a><p>The last one (9&#x2F;9) has a download link, but none of the others do.

As said the last time this was posted<p>Its because taxi drivers with Alzheimer&#x27;s will get complained about and ousted from the profession before their death<p>Meaning there are no cognitive benefits to extrapolate from this reality of using your brain, from this study

also probably higher rates of social interaction

I would be really interested in seeing an easily sortable and queriable dataset where you can sort also different causes of death and order them by all professions.

I guess it might be hard to keep being a taxi driver when your brain gradually subsymptomatically deteriorates because of illness that will eventually kill you.

Or taxi drivers with Alzheimer&#x27;s get fired or quit

Does this control for taxi driver ethnicity?

Could we just be seeing selection effects for very early indicators of alzehimers?

Maze Runner premise? Stimulate brain activity.

so - switch off your sat nav

My DoorDash drivers can barely tie their own shoes. So yes, probably something to this.

My Partner has absolute dogshit spatial memory. I visit a city once and I remember my bearings instinctively, probably due to playing a lot of badly designed mazelike Video games, but she can visit a City several times and still get lost going somewhere she has been before. Should we be worried?

Very flawed study. Looked at profession based on death certificate which is most recent profession.<p>Those with Alzheimer&#x27;s likely won&#x27;t last long as taxi drivers so they find a new profession. And voila their profession from the viewpoint of this study is no longer taxi driver.<p>Much surprise that our lauded peer review process didn&#x27;t catch this.