New Research Study to Investigate the Role of Stress in Dementia

Medical researchers have begun a study to find out if stress can trigger dementia. The investigation, funded by the Alzheimer’s Society, will monitor 140 people with mild cognitive impairment or “pre-dementia” and look at how stress affects their condition. The researchers will take blood and saliva samples at six-monthly intervals over the 18 months of the study to measure biological markers of stress. The results could offer clues to new treatments or better ways of managing the condition.

Past studies suggest mid-life stress may increase a person’s risk of Alzheimer’s disease. A Swedish study that followed nearly 1,500 women for a period of 35 years found the risk of dementia was about 65% higher in women who reported repeated periods of stress in middle age than in those who did not. Scottish scientists, who have done studies in animals, believe the link may be down to hormones the body releases in response to stress which interfere with brain function.

Understanding the risk factors for dementia and Alzheimer’s could provide one piece of the puzzle we need to take us closer to a treatment.

Stress Linked to Aging Chromosomes

A recent research study links stress with shorter telomeres – buffers that help guard chromosomes. Telomere regions deter the degradation of genes near the ends of chromosomes by allowing chromosome ends to shorten, which necessarily occurs during chromosome replication. Over time, due to cell division, our telomere ends become shorter. Stress can accelerate this aging process.

New research finds that telomere regions are significantly shorter in people with depression, which is often linked to irregular stress hormone levels. Furthermore, people without depression who reported feeling the most stressed also had shorter telomeres. And abnormal levels of stress hormones have been found in people with post-traumatic stress disorder, chronic fatigue syndrome and irritable bowel syndrome.

Shorter telomeres are linked to aging and poor health. Shortened telomeres impair immune function that make people more susceptible to various diseases, including cancer.

You may blame work stress for those gray hairs and wrinkles. But the impact of work stress on your chromosomes may have a bigger impact on your health, and ultimately your life.

The findings are in the Journal of Biological Psychiatry. [Mikael Wikgren, et al., “Short Telomeres in Depression and the General Population Are Associated with a Hypocortisolemic State”]

Court of Appeals Affirms WCAB Ruling on Paramedic’s Stroke Claim

In American Medical Response et al., v. Workers’ Compensation Appeals Board and Ronald Westerman, an unpublished opinion, the Second Appellate District reviewed a WCAB’s finding that the respondent, a former paramedic, sustained a stroke arising out of and in the course of employment. The WCJ in that case found that the paramedic was entitled to temporary disability and that he was permanently totally disabled.

That case involved a paramedic who suffered a stroke while at home, following a 36-hour work shift. The evidence showed that his job was stressful, involved long hours, required heavy lifting, and required significant periods of time during which he was sedentary. Additionally, he was 50 years old and may have been overweight at the time of the stroke. The evidence showed that he required home healthcare assistance and was not able to have gainful employment.

The injured worker’s treating physician determined that the stroke had an industrial component and that it could have been causally affected by hypertension, diabetes, hyperlipidemia and other stressors. A qualified medical examiner, however, concluded that the stroke was caused by a blood clot that traveled through a hole in the heart to the brain, but rejected as speculation the treating physician’s theory that hypertension, diabetes, stress and weight gain caused the stroke. The medical examiner stated that a “paradoxical embolus” brought about the stroke, conditional on the existence of a hole in the paramedic’s heart. He contended that a diagnostic test—specifically, an echocardiographic shunt study—could determine the existence of this defect in the atrial septum. The examiner also testified that, to a reasonable medical probability, the injury was industrial, based on the assumption that the paramedic had an intracardiac shunt.

The WCJ found that the stroke arose out of and in the course of employment. The WCJ also accepted the medical examiner’s conclusion that non-industrial causes of the stroke had been ruled out and that it was due to a paradoxical embolus.

The employer’s petition for reconsideration argued that the medical examiner’s opinion and conclusion did not amount to substantial evidence without the diagnostic test. It further contended that it had “authorized and agreed” to pay for the echocardiogram shunt test, but that the paramedic’s wife, as guardian ad litem, refused to allow the test based on her husband’s fragile health.

The WCJ recommended denial of reconsideration, rejecting the argument that the medical examiner’s diagnosis had to be supported by the echocardiographic shunt study. The WCJ stated that the diagnostic test was an invasive procedure and that the injured worker’s wife was justified in not agreeing to it. Moreover, the WCJ found that only reasonable medical probability, not reasonable medical certainty, was the standard for whether the injury was industrial.

CDC Reports a Rise in Occupational Injuries and Illnesses Among Seniors

Due to the downturn in the economy, more people are delaying retirement. A Centers for Disease Control and Prevention (CDC) Morbidity and Mortality Weekly Report (MMWR) revealed that older workers (individuals over the age of 55) accounted for 19 percent of all workers in the United States in 2009, making them the nation’s fastest growing sector of the working population.

The CDC’s report analyzed data from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII). According to these findings, approximately 210,830 nonfatal occupational injuries and illnesses in 2009 among senior workers led to lost workdays. The report also determined that in comparison to younger workers and workers of all ages, senior workers experienced greater rates of falls that occurred on the same level, fractures, and hip injuries.

To help lower incidents of workplace injuries and illnesses for older workers, the CDC advised employers to be proactive in identifying certain risks for older workers. The CDC also recommends that public health and research agencies evaluate the overall strain of occupational injuries and illnesses among older workers, aging-related risks, and effective ways to prevent accidents.

In addition to slip and fall injuries, seniors are also at special risk of occupational stress injuries. These injuries include the development and/or acceleration of heart disease, musculoskeletal disorders, mental health disorders, and cognitive deficits.

As more seniors continue to work or re-enter the workforce, the number of workplace injuries will likely continue to rise. Workers’ compensation is a public insurance program that may be a viable benefits system for many seniors.

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