Demanding jobs may increase survival in frontotemporal dementia

April 22, 2015, American Academy of Neurology

People with more demanding jobs may live longer after developing the disease frontotemporal dementia than people with less skilled jobs, according to a new study published in the April 22, 2015, online issue of Neurology, the medical journal of the American Academy of Neurology. Frontotemporal dementia, which often affects people under the age of 65, results in changes in personality or behavior and problems with language, but does not affect the memory.

"This study suggests that having a higher occupational level protects the brain from some of the effects of this disease, allowing people to live longer after developing the disease," said study author Lauren Massimo, PhD, CRNP, of the University of Pennsylvania in Philadelphia, Pennsylvania State University in State College and a member of the American Academy of Neurology.

The findings add evidence to the "cognitive reserve" theory that experiences such as more education and higher occupation and mental activity build up connections in the brain that create a buffer against disease.

"People with typically live six to 10 years after the symptoms emerge, but little has been known about what factors contribute to this range," Massimo said.

For the study, researchers reviewed the medical charts of 83 people who had an autopsy after death to confirm the diagnosis of frontotemporal or Alzheimer's disease. They also had information about the people's primary occupation. Occupations were ranked by U.S. Census categories, with jobs such as factory workers and service workers in the lowest level; jobs such as tradesworkers and sales people in the next level; and professional and technical workers, such as lawyers and engineers, in the highest level.

Researchers measured when the symptoms began by the earliest report from family members of persistently abnormal behavior. Survival was defined as from the time symptoms began until death.

The 34 people with frontotemporal dementia had an average survival time of about seven years. The people with more challenging jobs were more likely to have longer survival times than those with less challenging . People in the highest occupation level survived an average of 116 months, while people in the lower occupation group survived an average of 72 months, suggesting that individuals who had been in the professional workforce may live up to three years longer.

The study found that occupational level was not associated with longer survival for the people with Alzheimer's disease dementia. The number of years of education a person had did not affect the survival time in either disease.

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