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Strong social support systems, which in epidemiologic studies are associated with decreased morbidity and mortality, have been hypothesized to mitigate the harmful effects of stressful stimuli on the individual. The authors found that, among 256 healthy elderly adults, individuals with good social support systems tended to have lower serum cholesterol and uric acid levels and higher indices of immune function; these correlations were independent of age, body mass, tobacco use, alcohol intake, and degree of perceived psychological distress. Thus, social support systems may intervene between the stressful stimulus and the physiologic response to that stimulus.

We evaluated the association between nutritional status and cognitive functioning in 260 noninstitutionalized men and women older than 60 years who had no known physical illnesses and were receiving no medications. Nutritional status was evaluated by three-day food records and also by biochemical determination of blood levels of specific nutrients. Cognitive status was evaluated by the Halstead-Reitan Categories Test (a nonverbal test of abstract thinking ability) and by the Wechsler Memory Test. Subjects with low blood levels of vitamins C or B12 scored worse on both tests. Subjects with low levels of riboflavin or folic acid scored worse on the categories test. These differences remained significant after controlling for age, gender, level of income, and amount of education. "Subclinical" malnutrition may play a small role in the depression of cognitive function detectable in some elderly individuals, or depressed cognitive function may result in reduced nutrient intake.

The use of placebo is not old-fashioned, ineffective or unethical. It requires an ongoing, trusting relationship between the physician and the patient. Deception of the patient and self-deception must be avoided. Under these conditions, there are specific situations in which placebo is the treatment of choice.

Group psychotherapy is a recommended part of treatment for victims of incest--male and female--in childhood or adulthood. Self-help groups, treatment groups, individual treatment, family therapy, and other modalities may be used concurrently or sequentially. Special techniques include art therapy, play therapy, psychodrama, bibliotherapy, wilderness encounters, and educational techniques.

Social bonds were examined in 256 healthy, independent-living elderly men and women using the Interview Schedule for Social Interaction (ISSI). Multivariate techniques were used to test for relationships between six dimensions of social bonds, as measured by the ISSI, and demographic characteristics as well as scores from the Kellner-Sheffield Symptom Questionnaire, the Jacobs Cognitive Screening Exam, the Halstead Category Test and the Wechsler Memory Scale. The study participants reported involvement in a range of satisfying, supportive, interpersonal relationships. Significant associations were found between social bonds and income, marital status, work status and health status. Emotional status, cognitive functioning, and memory were found to be independent of social bonds in our statistical model.

The behavior of 15 internal medicine residents, each with 10 patients, was observed through a one-way mirror. Ratings by the patients of satisfaction with their physicians were also obtained. Patient satisfaction correlated strongly with ratings for physician courtesy and information-giving, Nonverbal behaviors such as eye contact, bodily positioning, and physical contact did not correlate with patient satisfaction. The correlations between physician behavior and patient satisfaction did not hold for the four women physicians studied.

This study was designed to obtain information on normal dietary intake and serum levels of choline in a healthy elderly population and to observe the relationship between blood levels of choline and cognitive function. Two hundred fifty-eight healthy volunteers with a mean age of 72 years were recruited, and blood samples and dietary histories were obtained. All subjects were ambulatory, living at home, free of serious medical illnesses, and taking no prescription medications. Cognitive abilities were assessed by the Halstead Category Test, a nonverbal test measuring abstract thinking, and the Wechsler Memory Scale, using the multiple scoring method, which measures both long- and short-term memory. The mean value for serum choline was 13.16 micron with a standard deviation of 3.31. Serum choline levels were found to increase with age, but no difference was found between serum choline levels for men and women. There was no association between dietary intake and serum choline levels, nor could a relationship be found between serum choline levels and cognitive function.