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Abstract-We compared the relations of 4 blood pressure (BP) indexes (pulse pressure [PP], systolic BP [SBP], diastolic BP [DBP], and mean arterial pressure [MAP]) with 25-year mortality rates for coronary heart disease (CHD), cardiovascular disease (CVD), and all causes in younger, middle-aged, and older men and women by using data from a long-term prospective epidemiological study of employed persons who were screened between 1967 and 1973. A single supine BP measurement was obtained at baseline. Vital status was determined through 1995. We report on 5 groups (total, 28 360 participants) consisting of men age 18 to 39, 40 to 59, and 60 to 74 years and of women age 40 to 59 and 60 to 74 years who were not receiving antihypertensive treatment, had no history of CHD, and did not have diabetes. Cox proportional hazards analyses were used to determine multivariate-adjusted hazard ratios with a 1-SD higher value for each BP index; Wald 2 tests were used to compare the strength of relations. Relations of PP were less strong than were those of SBP for all end points in all age/gender groups. SBP or MAP showed the strongest relations to all end points in all age/gender groups (hazard ratio, 1.17 to 1.36). The relations of SBP to death were stronger than were those of DBP, except for middle-aged men and for CVD in women. DBP showed significant positive associations with death, after control for SBP, in middle-aged participants. In conclusion, these data indicate that the long-term risk of high BP should be assessed mainly on the basis of SBP or of SBP and DBP together, not on the basis of PP, in apparently healthy adults. Key Words: blood pressure Ⅲ mortality Ⅲ coronary disease Ⅲ cardiovascular diseases Ⅲ epidemiology B lood pressure (BP) is an established major risk factor for coronary heart disease (CHD) and stroke. 1-6 Risk relations for both systolic BP (SBP) and diastolic BP (DBP) are generally regarded as continuous, graded, strong, independent of other risk factors, and etiologically significant. Some data indicate that SBP is a stronger predictor of cardiovascular disease (CVD) than is DBP. 7-10 Several recent epidemiological studies reported that pulse pressure (PP), the difference between SBP and DBP, is a useful predictor for CHD or total CVD, especially in middle-aged or older persons. [11][12][13][14][15][16][17][18] These reports emphasized the importance of PP as a CHD or CVD risk factor, especially because PP is often higher after age 50, apparently because of increased arterial stiffness. 19 -22 In regard to prior reports on PP, many did not compare the significance of PP with that of SBP or DBP, and some reports were studies on hypertensive persons only. Only 2 reports, from the Framingham Heart Study, compared the relations to CHD and CVD incidence of various BP indexes, 10,11 and such comparisons for total mortality in general populations have not been reported. Therefore, it is uncertain whether PP is superior to SBP or DBP in the prediction of future CHD, CVD, and all-cause mortality in various ag...

Speech and language assessment in 30 patients with dementia of the Alzheimer type and in 70 normal controls revealed that all Alzheimer patients were aphasic. Throughout most of the course, the language disorder resembled transcortical sensory aphasia, and increasing language impairment correlated with increasing severity of dementia. Aphasia was present regardless of age of onset or family history of dementia. Aphasia is an important diagnostic criterion of dementia of the Alzheimer type.

The purpose of the study was to assess whether depressed geriatric patients would respond to group psychotherapy and, if so, would they respond differently to cognitive-behavioral and psychodynamic group psychotherapy. Thirty-three persons entered the study and 20 completed the 9-month course of treatment. Patients in both types of groups showed statistically and clinically significant reductions on observer-rated measures of depression and anxiety, as well as on self-report measures of depression. There were no clinically significant differences, but a statistically significant difference between the types of groups was found for the Beck Depression Inventory and this favored the cognitive-behavioral treatment. Limitations on interpretation of these results because of the lack of a control condition are discussed. Approximately 7% to 11% of the American population age 65 and older suffer from depression (Gurland, 1976), making the treatment of depression in the elderly an important concern of both research and practice. Yet, few psychologists (Dorken & Webb, 1979) or psychiatrists (Marmor, 1975) in private practice see elderly patients, and the preferred mode of treatment for this age group appears to be pharmacological (Ford & Sbordone, 1980). However, the use of antidepressants may be contraindicated for a large number of el

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