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Abstract Details

The Case for an Empathy Reserve: Corroborating the Effect of Occupation History on Symptom Age at Onset in Frontotemporal Dementia
Aging, Dementia, and Behavioral Neurology
Aging and Dementia Posters (7:00 AM-5:00 PM)
023
To investigate the impact of occupational history on symptom onset in frontotemporal dementia (FTD).

Cognitive reserve refers to the resilience education and life-time mental activity confer against neurodegenerative disease. Previous findings, primarily in Alzheimer’s disease, suggest that occupational complexity is associated with delayed onset of disease. Careers that differentially emphasize empathizing versus systematizing may represent variable sources of occupational complexity. High levels of systematizing are valued in science, technology, engineering and mathematics (STEM) professions whereas empathizing may be valued more in the arts, personal care, education and homemaking. In a prior study of 638 FTD evaluated at UCSF, we observed elevated rates of STEM professionals compared to US general population estimates and a significantly earlier symptom age at onset (AAO), compared to FTD in empathizing-based careers.
To independently test the impact of empathizing versus systematizing occupational history on AAO, we conducted a systematic PubMed review with search terms “Frontotemporal Dementia,” “Primary Progressive Aphasia,” and “case series,” excluding articles from UCSF and those without occupational history, resulting in 164 articles, 222 FTD subjects, for analysis. Occupations were codified according to the United States Bureau of Labor Statistics job classification, and based on our prior study, transformed further into occupation classes: systematizing, empathizing, or neither. Kaplan-Meier AAO vs. occupation class curves were generated.

15.3% (34/222) FTD held systemizing-related occupations, which is statistically higher than the 6.2% US general population STEM prevalence (p < 0.001). In those with sporadic FTD, systematizing-related occupations demonstrated a significantly earlier AAO, 5 years, compared to empathizing-based careers (log odds p = 0.04).
These findings corroborate our prior observations that occupational complexity has an opposite effect in FTD to that of Alzheimer’s disease. As FTD is associated with selective degeneration of regions supporting empathizing behavior, an empathy-reserve, conferred by occupation, may postpone disease onset in this population.
Authors/Disclosures
Eleanor Palser, PhD (University of Calfiornia, San Francisco)
PRESENTER 		Eleanor Palser has nothing to disclose.
No disclosure on file
Emily Eijansantos, MD (University of California, San Francisco) Dr. Eijansantos has nothing to disclose.
Kyra Neylan, MD Kyra Neylan has nothing to disclose.
No disclosure on file
Rian L. Bogley (UCSF) Mr. Bogley has nothing to disclose.
David Perry, MD The institution of Dr. Perry has received research support from NIH/NIA.
Gil D. Rabinovici, MD, FÂ鶹´«Ã½Ó³»­ (UCSF Memory & Aging Center) Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Eli Lilly. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alector. Dr. Rabinovici has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Merck. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novo Norodisk. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Consultant for C2N. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Johnson & Joihnson. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Peerview. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Rabinovici has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA. The institution of Dr. Rabinovici has received research support from NIH. The institution of Dr. Rabinovici has received research support from American College of Radiology. The institution of Dr. Rabinovici has received research support from Alzheimer's Association. The institution of Dr. Rabinovici has received research support from Rainwater Charitable Foundation. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Topic Chair, Course Director and teacher with Â鶹´«Ã½Ó³»­. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Grant reviewer with NIH. Dr. Rabinovici has received personal compensation in the range of $500-$4,999 for serving as a Invited speaker with ANA.
Adam L. Boxer, MD, PhD (University of California, San Francisco) An immediate family member of Dr. Boxer has received personal compensation for serving as an employee of Kaiser Permanente. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ono. Dr. Boxer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Oscotec. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arrowhead. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Neurocrine Biosciences. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Switch. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Arvinas. Dr. Boxer has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Alector. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Boxer has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Transposon. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen . Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Boxer has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Boxer has stock in Alector. Dr. Boxer has stock in Arvinas. Dr. Boxer has stock in Neurovanda. The institution of Dr. Boxer has received research support from Biogen. The institution of Dr. Boxer has received research support from Eisai. The institution of Dr. Boxer has received research support from Regeneron. The institution of Dr. Boxer has received research support from NIH. The institution of Dr. Boxer has received research support from Bluefield Project-5. Dr. Boxer has received research support from Rainwater Charitable Foundation. Dr. Boxer has received research support from GHR Foundation. Dr. Boxer has received intellectual property interests from a discovery or technology relating to health care.
Howard J. Rosen, MD (UCSF) Dr. Rosen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly . Dr. Rosen has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Alector. The institution of Dr. Rosen has received research support from NIH. The institution of Dr. Rosen has received research support from State of CA. Dr. Rosen has a non-compensated relationship as a Consultant with Prevail Therapeutics that is relevant to Â鶹´«Ã½Ó³»­ interests or activities. Dr. Rosen has a non-compensated relationship as a consultant with Alchemab that is relevant to Â鶹´«Ã½Ó³»­ interests or activities.
Joel Kramer, PhD (UCSF Medical Center) The institution of Dr. Kramer has received research support from tau consortium. Dr. Kramer has received publishing royalties from a publication relating to health care.
Lea Grinberg Lea Grinberg has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Curasen Inc. The institution of Lea Grinberg has received research support from NIH. The institution of Lea Grinberg has received research support from Eli Lilly. The institution of Lea Grinberg has received research support from BrightFouus. The institution of Lea Grinberg has received research support from Rainwater Charity Foundation.
William W. Seeley, MD Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Council. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint Global Consulting. Dr. Seeley has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BridgeBio. Dr. Seeley has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Biogen. Dr. Seeley has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Lyterian Therapeutics. The institution of Dr. Seeley has received research support from NIH. The institution of Dr. Seeley has received research support from Rainwater Charitable Foundation. The institution of Dr. Seeley has received research support from Bluefield Project to Cure FTD. The institution of Dr. Seeley has received research support from Chan-Zuckerberg Initiative.
Katherine P. Rankin, PhD (University of California San Francisco) The institution of Dr. Rankin has received research support from Marcus Foundation.
Virginia Sturm, PhD Dr. Sturm has nothing to disclose.
Maria Luisa Gorno Tempini, MD, PhD (UCSF Memory and Aging Center) The institution of Dr. Gorno Tempini has received research support from the NIH.
Bruce L. Miller, MD, FÂ鶹´«Ã½Ó³»­ (University of California, San Francisco) Dr. Miller has nothing to disclose.
Zachary Miller, MD (UCSF Memory and Aging Center) Dr. Miller has nothing to disclose.