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'Job choice affects alzheimer's'

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Nursing Times’ weekly series sifts the facts from the fiction. This week 'Job choice affects alzheimer's'

What did the media say?

Reports highlighted a study that suggested patients with more demanding jobs and better education are less likely to develop Alzheimer’s disease. They suggested that people in this group may have developed a ‘buffer’ against the effects of dementia on the brain.

University educated people may be able to compensate for the damage caused to the brain by the disease and allow it to continue functioning, the reports added.

Previous studies had linked increased mental stimulation with a reduction in the likelihood of developing Alzheimer’s.

What did the researchers say?

The paper focused on the results of a study involving 242 patients, 72 with amnestic mild cognitive impairment (aMCI) and 144 controls.

After a follow-up period of 14 months, 21 people with aMCI were diagnosed with Alzheimer’s disease.

However, when the MRI scans of people with the same level of memory problems were compared it was found that patients with higher levels of education or a demanding occupation tended to have more extensive damage than those with similar level of cognitive impairment but lower educational attainment.

The study findings suggest that the brains of patients in the more educated group could better withstand the damaging effects of Alzheimer’s. This may be due to protective effects of educational and occupational challenges or to genetic factors that enabled them to achieve and to maintain functioning.

‘This study suggests that education and occupation may be proxies for brain functional reserve, reducing the severity and delaying the clinical expression of Alzheimer’s disease pathology,’ said the authors from San Rafaelle University, Milan.

What does this mean for nursing practice?

The small sample size means that further work needs to be done before any changes to clinical practice can occur.

But Linda Nazarko, nurse consultant for older people, urged nurses to make patients aware that improving their physical health is likely to lead to better mental health later on in life.

Ms Nazarko said: ‘If you are going to have a healthy old age, you have to start when you are about 45. If you do the right things at that age you can reduce the chances of illness when you are older.’

Neurology (2008) 71: 1342–1349

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