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Alzheimer’s is a pervasive and devastating disease. An estimated 6.9 million Americans were living with this common type of dementia in 2024, and that number is expected to grow by 2060 unless medical breakthroughs alter its course. The condition is also the fifth-leading cause of death among those 65 and over.

With Alzheimer’s becoming increasingly common within a rapidly aging population, exploring ways to reduce the risk is vital.

That’s why a recent study suggesting certain careers may reduce Alzheimer’s risk is so important to understand — not, of course, because everyone should change their job to avoid dementia, but because understanding why those jobs have a protective effect can be important in identifying new methods of disease prevention.

These two jobs appear to lower dementia risk

To understand whether doing certain work can affect the chances of developing Alzheimer’s, researchers reviewed death certificates from the National Vital Statistics System in the United States that also included occupation.

They discovered that among the 443 occupations studied, workers in two particular career fields had a noticeably lower risk of developing his condition.

The two jobs that appeared to significantly lower the risk were taxi driver and ambulance driver. In fact, just 0.91% of taxi driver deaths were attributed to Alzheimer’s, while only 1.03% of ambulance drivers died of this disease. By comparison, 1.82% of CEOs died of Alzheimer’s, which is fairly close to the overall average death rate from this dementia variant.

Although the difference may not seem very substantial when looking at the raw percentages, ultimately, these numbers show that ambulance drivers and taxi drivers experience around 40% fewer Alzheimer’s-related deaths compared with the general population.

Why are taxi and ambulance drivers experiencing a lower Alzheimer’s risk?

While considering the link between specific careers and a reduced risk is important, determining why this link exists is even more essential. Developing a deeper understanding of factors affecting Alzheimer’s risk increases the likelihood of finding a cure or at least identifying effective prevention methods.

Fortunately, experts were able to determine two key factors that shed more light on the potential reasons for the low prevalence of the disease among taxi and ambulance drivers.

First was the fact that other transportation professionals did not experience a decline in risk. Aircraft pilots and ship captains both had higher-than-average rates of Alzheimer’s disease at 2.34% and 2.12%, respectively. Bus drivers, on the other hand, had a 1.6% death rate from the condition, which is closer to the average among all workers.

Second, ambulance and taxi drivers did not experience lower rates of other types of dementia beyond Alzheimer’s.

One possible explanation for the lower risk is that both taxi and ambulance drivers must regularly exercise their spatial and navigational skills in real time. Moreover, they must do so much more often than other transportation professionals because ambulance and taxi drivers regularly travel different routes in unfamiliar locations, rather than traveling the same route regularly.

Because they must adjust to new conditions in unfamiliar areas, taxi and ambulance drivers may use their hippocampus more regularly, as this is the part of the brain that’s exercised when deploying these skills. This theory is also supported by older studies that demonstrated taxi drivers may experience enlargement in parts of the hippocampus.

“Our results highlight the possibility that neurological changes in the hippocampus or elsewhere among taxi and ambulance drivers may account for the lower rates of Alzheimer’s disease,” senior author Anupam B. Jena, MD, PhD, a physician in the Department of Medicine at Massachusetts General Hospital said of the findings.

This study doesn’t imply that relying on GPS navigation apps while driving will cause Alzheimer’s, but there is evidence that GPS can help people with mild dementia avoid getting lost.

Translating this study into action for you

There is, of course, a limit to the number of people who can work as taxi or ambulance drivers, but identifying the lower rates of Alzheimer’s among people within these professions provides clues into how those concerned about the disease could reduce their risk.

For example, activities like outdoor orienting, which experts have revealed can help develop spatial memory, could help workers in other professions strengthen crucial areas of the brain.

Past research has also revealed that dancing challenges the brain in important ways, especially when learning complex steps such as the waltz and swing dancing. As with navigation, dancing requires the brain to manage an internal three-dimensional map; however, instead of remembering a route, a dancer must recall a sequence of steps and where to place their body.

Games, puzzles, and continued learning are associated with a lower dementia risk, including spatially challenging games like jigsaw puzzles. But what about 3D versions of games? (Remember Dr. Spock’s three-dimensional chess game in Star Trek?) Some studies have shown that playing 3D video games may keep older players sharp. For a truly mind-bending experience, try downloading the app for Monument Valley on your phone, desktop,p or tablet. Your avatar will travel through a beautiful world by rotating building pieces; it’s much more difficult than it sounds.

Ultimately, maintaining a strong mind and body can only help you. While it may not directly prevent Alzheimer’s, challenging your brain’s spatial awareness and memory can help you maintain overall good mental and physical health for as long as possible as you enter older age. It is worth the effort to reduce your overall disease risk and, hopefully, enjoy a happier, healthier retirement.

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One of your best wellness tools may be a journal. Journaling offers an array of benefits — from easing stress to sparking self-discovery.

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Journaling

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Is it ever okay—or at least, understandable—for one child to bully another?

I spend a lot of time speaking to parent groups and students about bullying, and it’s common for parents to approach me after a talk with questions about their personal situation. A mother once asked for my thoughts about a situation in which her eight-year-old son had been accused of bullying another boy.

In my experience, parents often have a hard time believing that their child could ever engage in bullying; this mother clearly accepted that the behavior had happened, yet she just as clearly felt that there were extenuating circumstances. She pointed out that the target had the annoying habit of picking his nose, and this had bothered her son, who had lashed out.

She hedged; surely, she thought, there could be circumstances under which it’s acceptable for one child to bully another.

If your child is being accused of bullying another, it can be surprising and upsetting. Beyond those understandable emotions, as a parent, you have many options to help your child understand their behavior and why it was seen as bullying.

Let’s first define what it is we are talking about: bullying means that someone repeatedly and deliberately hurts a less powerful person. Bullying is a very unhealthy and potentially damaging behavior, for both the target and the bully. Research tells us that children who bully carry mental health consequences like depression and anxiety into adulthood. This is especially true for kids who are both bullies and victims.

I think most people would agree that bullying sometimes calls for punishment, and often calls for interventions, but is bullying ever a behavior that calls for understanding? If your child is being aggressive once (which doesn’t meet the definition of bullying), and in self-defense, that may indeed be excusable. On the other hand, if your child is bullying, that repeated torment is not excusable. I reminded the mother whose son bullied the nose-picking child that bullying is harmful to both individuals, so even when it happens because of a provocation, it shouldn’t be shrugged off.

What’s interesting is that generally, children don’t excuse bullying. In a study in which scientists interviewed elementary school children (both those involved and uninvolved in bullying) in Sweden to understand how kids view bullying, the students tended to think that bullies were either psychologically troubled, or alternatively, attention seekers—bullying to gain social status (in other words, that they wanted other children to see their power and admire it).

Kids who bully others, however, tend to have justifications for their behavior. In my study of more than 2,200 teens, about 62 percent of those who admitted bullying others offered one or more of the following explanations: “People didn’t try to understand my point of view,” or “I needed to show I wasn’t intimidated or afraid,” or “My behavior was taken way too seriously; I never meant it.”

It’s important to understand that kids can engage in bullying for a variety of reasons. Parents may think of bullying as a behavior reserved for only truly disturbed kids. The research, however, shows that some youth who bully are otherwise doing well socially, while others, who tend to be both bullies and targets, struggle more with making friends and being social. It can be difficult to believe that a child who does well in school and has friends could actually be a bully.

What should parents do when their children are accused of bullying? How should they handle their child’s protests that they were justifiably provoked? Should they believe their child and accept the reasons for the bullying? Should the response be punishment, intervention or understanding—or all three?

The word bullying tends to be overused, and is sometimes applied to any situation (repeated, deliberate or not) when someone hurts someone else. How you approach the situation may be completely different if the aggression in question only happened once, or between two children with relatively equal social and physical power, which likely would not be bullying.

If the power dynamic is unequal, and it appears to be a bullying situation, talk to everyone to determine the facts. Make it clear to everyone involved that you’re approaching this with an open mind. The school’s perspective is almost certain to be different from your child’s. It’s not hard to imagine a situation where a school counselor explains that your child has bullied another student, but your son or daughter claims they were just mad and not thinking. Bullying is a behavior that is planned out. It is not an impulsive, one-time response to someone else’s provocation. A target may have engaged in nose-picking, and that may have been genuinely irritating, but repeated aggression against them isn’t impulsive or thoughtless.

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In 2015, I was teaching a class on estate planning at a local continuing care retirement community. During the audience-participation section, I asked the attendees if they had recently updated their documents. A woman in a wheelchair who’d appeared to be asleep for the entire class, yelled, “None of your (bleeping) business.”

She may have had a point, but it was the last time I raised my hand to teach at that community.

Between 2015 and 2020, I spent many a day teaching financial planning classes for retirees at continuing care retirement communities (CCRCs). I could tell you which communities leaned young, old, left, and right. In Washington, D.C., that left or right leaning is often a dealmaker or breaker.

The point is that these retirement communities are all different. The same person may love one and hate another, which is where we will land in this article. Whether a CCRC makes sense depends on you, your priorities, and how aligned they are with a specific community.

Below, I will highlight major pros and cons as you consider your next move, literally.

PROS OF CCRCS

1. The care will be there when you need it

If you pick the right community, this will be your last move. Residents can move along the spectrum from independent living to nursing care. You may change locations within your community, but you will not be moving furniture up and down stairs right when you start to need help.

2. You’ll have a ready-made community

According to that often-cited Harvard study on happiness, two of the greatest drivers of happiness in retirement are health and social connections. Hopefully, the continuum of care helps with the former. The built-in community of a CCRC should help with the latter.  Having friends in a community is a real bonus, as this can shorten the friend-making curve.

3. Your home will be turn-key, maintenance-free

The general advice for when to move into a CCRC is when you are still active and independent. That means you’re still going places.

You don’t want to have to worry about a pipe bursting when you’re skiing the Rockies. You don’t want the call telling you your HVAC is broken during your summer trip to Europe.

These communities, even if they are not really rentals, carry many of the benefits of being a tenant. And as you age, those benefits become even more important.

CONS OF CCRCS

1. Get ready for hefty entrance fees and monthly fees

The financial structures of these communities come in all shapes and sizes. For the purpose of this column, we are excluding rental communities, and we are not differentiating between A-, B-, and C-level plans.

The expense of a CCRC comes in the form of a buy-in and an ongoing monthly fee. You can think of this as a down payment and a mortgage payment.

The buy-ins can be large, often at $100,000 to $500,000 or more, which is one reason they are on the “cons” list. On top of that, monthly fees for those in independent living can be in the neighborhood of $2,500 to $5,000.

Another con: Entrance fees are often touted as, at least partially, refundable. While this is the case, even a 100% refundable buy-in doesn’t adjust for inflation.

So, if all goes according to plan and you spend your 20 greatest years in the community, the amount refunded to your estate may be worth half what you put in, when you account for inflation.

2. Expect rising costs

It’s 2025, and we are all used to living with rising prices. It’s easy to forget that the decade between 2010 and 2020 had almost no inflation, despite the Fed’s best efforts.

During this period, advisers in my firm got into hot water telling a few of our clients they couldn’t afford a particular community. We received some unhappy calls from the community’s sales office.

The thing that made this community unaffordable was not the buy-in fee. In the D.C. metro area, clients can usually cover large buy-ins with the equity realized from the sale of their forever home.

It was the 4% COLA, which caused the monthly fees to increase every year on a compounding basis, regardless of the inflation rate.

Even very secure financial plans can get a little iffy when you change inflation from 3% to 4%. If you’re considering a move, I’d encourage you to build out a plan in the free version of the software we use.

3. Prepare for a lifestyle adjustment

Earlier, I cited the conventional wisdom of moving into a CCRC while you’re still active and independent. The problem with this is that you’ll likely be one of the youngest in the community. You don’t want to do water aerobics if you can still swim laps. You’re unlikely to take the shuttle to the zoo if you can walk there.

It’s easy to age up quickly, though. Pretty soon, you’ll be yelling at me from a wheelchair.

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