Can writing reduce stress and improve health in older people?

Expressive Writing Intervention (3 days of consecutive writing, 20 minutes of writing on each day). WRITING INTERVENTION: Intervention: Expressive Writing Group - Participants in this group will be asked to write about their most traumatic/upsetting experience in their life. Specifically, to disclose their deepest thoughts, feelings, and emotions about the event, ideally not previously shared with others. Control: Time Management Group - Participants allocated to this group will be asked to write descriptively about time management (i.e. what they will be doing the next day). This group will be asked not to mention emotions, opinions, or beliefs. Participants will be randomly allocated to either the intervention group or the control group by the RA. Each participant will meet with a research assistant (RA) one-on-one, during which the RA will explain the writing instructions (either the Expressive Writing or Time Management instructions), and provide the participant with an exercise book and pen. The RA will telephone each participant the next day to remind the participant to complete their writing task, and to answer any questions they may have. The RA follows up with each participant after a few more days to ensure the three writing tasks have been completed. The writing tasks are unsupervised - they are completed by the participant at a time and place most convenient to them; however, we request the participant finds a quiet place to do the writing, so they will not be disturbed during the 20 minutes. The exercise books are collected approximately two weeks after they have finished the writing task. The writing is not shared with other participants. Only the researchers and RA have access the essays for analysis. The researcher collects the exercise books from the participants, and gives these books to the RA. The RA then re-assigns a new ID code to each exercise book (and 'blacks out' the former ID code), and returns the book to the researcher, in order for the researcher to transcribe the essays electronically yet remain blinded to group allocation. (i.e. ID code 2wf will be reassigned a new code by the RA (i.e. 3mp) to prevent the researcher from inadvertently associating the former ID code (2wf) with the essay). WOUND HEALING: Punch Biopsy: The punch biopsy occurs approximately two weeks after the first writing session. The punch biopsy procedure is performed by a licensed general practitioner (GP). The punch is 4mm diameter, and is created on the upper, inner non-dominant arm, under local anesthesia. Once the wound is created, a photo of the wound is taken (baseline). The wound is then covered with DuoDerm (a hydrocolloid dressing) and a waterproof bandage for 7 days. After 7 days, the wound is gently cleaned with sterile saline, photographed, and redressed. This same procedure is carried out every 3-4 days until the wound is healed. Healed is defined as full re-epithelialization of the wound, as determined by the study dermatologist, based on the wound photographs taken at each time point. BLOOD DRAWS: One blood sample is taken the day of the writing instruction administration, and a second blood sample is taken the day of the punch biopsy.