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To: Jim Burnham who wrote (98)	7/1/1999 5:19:00 PM
From: Jim Burnham	Respond to of 294

Mental distress tied to hip fracture risk NEW YORK, May 26 (Reuters Health) -- Loneliness and depression can increase the risk of hip fracture in older women, according to study findings. Mental distress may increase the likelihood for hip fracture by promoting ''health neglecting behavior such as bad nutrition and smoking,'' write a team of researchers led by Dr. Lisa Forsen of the National Institute of Public Health in Oslo, Norway. Their findings are published in the June issue of the Journal of Epidemiology and Community Health. The researchers conducted interviews with over 18,000 Norwegian women over 50 years of age, measuring self-reported levels of ''life dissatisfaction, nervousness, loneliness,'' and other emotional complaints. They then followed this group, recording hip fractures that occurred in these women over the next 3 years. The investigators report that, even after adjusting for age and medication use, ''the 10% of women with the highest mental distress had a twofold increased risk of hip fracture compared with the 10% of women with the lowest mental distress.'' In the past, researchers have speculated that the rise in hip fracture among mentally distressed women may be due, in part, to their increased use of tranquilizers and other psychiatric drugs. However, Forsen's team reports that ''daily users of medication had (a) 50% increased risk of hip fracture,'' independent of their level of mental distress -- indicating that drug-taking and unhappiness may each work separately to increase risks of hip fracture. The authors speculate that besides promoting unhealthy behaviors, mental distress may also raise blood levels of the stress hormone cortisol, which has been linked ''bone loss and increased fracture risk.'' They conclude that ''watchful care with respect to prevention of hip fracture should be given women with high mental distress, especially those who use medicine daily.'' SOURCE: Journal of Epidemiology and Community Health 1999;53:343-347.

To: Jim Burnham who wrote (98)	7/1/1999 5:29:00 PM
From: Jim Burnham	Respond to of 294

Stress linked to memory impairment NEW YORK, Jun 14 (Reuters Health) -- Prolonged stress can cause the memory to fail, report US researchers. A study in human volunteers shows that exposure to high levels of the stress hormone cortisol can impair what scientists call ''verbal declarative memory,'' or the ability to remember words, details, and phone numbers. The hormone, which is produced by the adrenal glands during physical and psychological stress, can interfere with the ability to recall verbal information because of its effects on the brain, according to a report published in the June issue of the Archives of General Psychiatry. Every day for 4 days, 51 people were given a dose of cortisol mimicking a mildly stressful event, a higher dose mimicking a major stress, or a placebo (inactive drug). About 93% of those given the higher dose of the hormone had more difficulty recalling information in a paragraph read to them compared with those given low doses or a placebo, report the researchers. Six days after the cortisol treatment was halted, all the groups in the study performed equally well on memory tests, suggesting that high levels of the stress hormone were responsible for the previous poor showing on these tests in the high-dose cortisol group. The investigators suggest that ''several days of exposure to cortisol at doses and plasma concentrations associated with physical and psychological stress in humans can reversibly decrease specific elements of memory performance in otherwise healthy individuals.'' The high dose of cortisol used in the study was roughly equivalent to ''the kind of physical stress that occurs during a major abdominal surgery,'' said lead study author Dr. John Newcomer in an interview with Reuters Health. Newcomer also compared this high level of stress to ''the psychological stress when Kosovars saw their relatives murdered, their villages burned, and were forced to leave the country.'' It is possible that mild stress may also cause some people to produce a large amount of cortisol, and thus have some impact on memory. Or people who are under chronic stress may develop a tolerance to high levels of the hormone, according to Newcomer, an assistant professor of psychiatry and psychology at the Washington University School of Medicine in St. Louis, Missouri. Cortisol appears to be ''responsible for changing the way energy is being used by different tissues,'' said Newcomer. In particular, the hippocampus, a region of the brain that plays a key role in memory, has a particular abundance of receptors than bind to cortisol. SOURCE: Archives of General Psychiatry 1999;56:527-533.