Mayo Clinic Health Letter, September 2011 Highlights: Substantial Recovery from Hip Fractures is Possible; Treating Causes

ROCHESTER, Minn.--(BUSINESS WIRE)-- Here are highlights from the September issue of Mayo Clinic Health Letter. You may cite this publication as often as you wish. Reprinting is allowed for a fee. Mayo Clinic Health Letter attribution is required. Include the following subscription information as your editorial policies permit: Visit or call toll-free for subscription information, 1-800-333-9037, extension 9771.

Hip Fractures: Many Regain Mobility

ROCHESTER, Minn. -- The fear of fracturing a hip looms large for many older adults -- with justification. An estimated 20 percent of older adults who sustain a hip fracture die within a year of injury. Others experience loss of mobility and independence.

The September issue of Mayo Clinic Health Letter covers hip fractures and treatment options, noting that the prognosis isn’t always dire. Highlights from the article include:

  • Hip fractures typically result from a mild trauma, such as a fall from a standing position. They are a medical emergency. Pain is usually severe, and an ambulance should be called for transport to the emergency department.
  • Surgery is almost always the best treatment for hip fracture, and outcomes are better when surgery is done within 24 hours of the injury. There are a range of surgical options, from placement of screws for hairline cracks to full hip replacement. Surgical procedures are generally very effective.
  • The primary goal of hip repair surgery is to get patients back on their feet. Most patients are out of bed -- with the help of a therapist and supportive equipment -- within 24 hours of surgery. Early movement helps reduce the length of hospital stays and the risk of complications such as blood clots and bedsores.
  • Hospital stays after hip repair surgery usually last less than a week. Some people go home if help is available. Some transition to an extended-care facility for one to several weeks of rehabilitation.

While hip fractures are worrisome, substantial recovery from hip repair is common. The prognosis is better for those who are in generally good health and are mobile and active prior to the injury.

Sleep Deprivation: Most Underlying Causes Treatable

ROCHESTER, Minn. -- Sleeplessness is not a normal part of aging. The September issue of Mayo Clinic Health Letter looks at the myriad of causes that can contribute to sleep difficulties in older adults. Most of the underlying causes of sleeplessness can be treated, and sleep may return to normal.

Causes of sleeplessness include:

Sleep disorders: Sleep-related leg cramps, obstructive sleep apnea, periodic leg and arm movements and restless legs syndrome can interfere with sleep. A Mayo Clinic study of aging adults found that more than half of 892 participants had signs of at least one sleep disorder other than insomnia.

Pain: Difficulties falling asleep or staying asleep often are related to poor pain control for heartburn, arthritis, back pain and other health concerns.

Nighttime urination: The urge to urinate is a common reason that older adults wake at night.

Illness: Coughing, shortness of breath and even itching can disrupt sleep. Mental health conditions, such as depression, often are associated with sleep difficulties.

Medications: Many medications can interfere with sleep. Some include nonprescription decongestants, pain relievers containing caffeine, some antidepressants and corticosteroids.

Menopause: About half of the women in menopause report sleep difficulties such as hot flashes and night sweats.

It’s important to talk to a doctor when sleep is elusive. Sleep patterns change with age. But in general, getting less than seven hours of sleep on a regular basis interferes with concentration, memory and making decisions. Ongoing sleep deprivation even interferes with the ability to recognize fatigue.

Mirror Neurons: Brain Cells with Empathy

ROCHESTER, Minn. -- Scientists have identified specialized brain cells called mirror neurons that may play a role in empathy, socializing and addiction.

The September issue of Mayo Clinic Health Letter reviews current knowledge of mirror neurons which were identified by accident nearly two decades ago. Researchers were studying brain activities in monkeys. They found that the same neurons fired up when a monkey reached for its own food as well as when a monkey watched another monkey perform the same action.

In the years since, brain imaging studies have demonstrated the presence and probable locations of mirror neurons in the human brain. It is thought that the mirror neurons allow people to adopt another person’s point of view and interpret the person’s intentions.

Researchers have looked at what may occur when mirror neurons don’t function as expected. Of particular interest is autism, a condition where people have difficulties with social interactions. Studies have shown that people with severe symptoms of autism have less active mirror neuron systems.

To counter the lower mirror neuron activity, therapists have used imitative behavior therapy with autistic children. The therapist imitates the actions of the autistic child to encourage social engagement. Results of this approach have been encouraging.

Mirror neurons may be a reason that stopping addictions -- to tobacco, alcohol or drugs -- can be so difficult. Researchers have looked at brain images generated while a smoker watched videos of a person smoking or opening a package of cigarettes. Smokers also watched videos of others drinking soda or opening cans of soda. The brain images showed higher mirror neuron activity with the smoking-related video.

The scientific community isn’t in agreement over what mirror neurons do or even if they actually exist, not surprising given this complex aspect of the brain function. Research continues on the many questions to be answered about how mirror neurons might relate to learning, emotional processing and empathy.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today’s health and medical news. To subscribe, please call 1-800-333-9037 (toll-free), extension 9771, or visit

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