In this post-Sept. 11 season, more people than usual are facing the holidays soon after a loss, and rituals that brought joy in years past may turn into stark reminders of missing loved ones. But ignoring your grief and trying to maintain false cheer are the worst things you can do, says Marianne Wamboldt, M.D., director of the Center for Stress and Anxiety Disorders at the National Jewish Medical and Research Center in Denver. Ignoring the pain doesn't make it go away; if anything, that may intensify it. She advises taking that fact into account by simplifying your holiday plans and scaling back on potentially stressful activities. Set aside some time to remember the lost loved one, but try to limit the time so it doesn't overwhelm the entire holiday. Developing new rituals, such as engaging in volunteer work or a new family activity, is another way of honoring the departed without getting mired in the past.

HORMONES HELP WOMEN MAINTAIN MENTAL FUNCTION

Lifetime exposure to hormone replacement therapy may be associated with better maintenance of cognitive mental functions such as memory in older women, say the authors of a study in the current issue of the journal Neurology. Doctors at 4 leading medical centers around the country assessed more than 2,000 women aged 65 or more and followed them for 3 years. During that time they recorded any changes in the women's mental status, as well as the participants' use of HRT. "This study shows an apparent benefit of lifetime HRT use on cognitive function in nondemented older women," says Michelle C. Carson, PhD, of Johns Hopkins University in Baltimore, and one of the authors of the paper. Women over age 85, who were at greatest risk of cognitive decline, benefitted the most from HRT. Several trials are now under way to examine the effect of HRT in preventing Alzheimer's disease.

LEISURE ACTIVITY DECREASES RISK OF ALZHEIMER'S DISEASE

Also in this month's Neurology, investigators at Columbia University in New York City report that reading and engaging in other leisure activities may reduce the risk or delay the onset of the symptoms of Alzheimer's disease. After following 1,772 people aged 65 or more for 7 years, they found that "subjects with high leisure activity had 38 percent less risk of developing dementia," says Yaakov Stern, PhD, one of the study's authors. The study also suggested that participation in leisure activities may have a cumulative effect, with an additional 8 percent risk reduction associated with each leisure activity engaged. Intellectual activities such as reading were associated with the highest benefit, although any kind of leisure activity proved effective. Says Dr. Stern, "Managing intellectual and social engagement through participation in everyday activities seems to buffer healthy individuals against cognitive decline in later life."

SPRAY HELPS CLEAR SINUS INFECTION

Patients with sinus infections recover faster and have briefer symptoms when they add fluticasone, a steroid nasal spray, to their usual regimen of antibiotics and decongestants. Doctors at Duke University Medical Center in Durham, NC, studied 95 people with a history of recurrent or chronic sinusitis by having 47 patients take 2 puffs of fluticasone in each nostril for 21 days, and comparing their results to those of 48 patients who puffed on a placebo spray. All patients also received a decongestant and an antibiotic. Of the 88 patients who completed the study, 93 percent of those taking fluticasone reported a cure or significant improvement of their sinus problems, compared to only 74 percent of those receiving the placebo. Symptoms also resolved sooner among patients in the fluticasone group. The authors conclude that intranasal steroids should be a part of the therapeutic regimen for people with chronic or recurrent sinusitis. GlaxoSmithKline, which makes fluticasone under the brand name Flonase, funded the study.

(Editors: For more information on LOSS, call 303-398-1002; on HORMONES or ALZHEIMER'S, call 651-695-2737; and on SINUSITIS, call 919-684-4148.)