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Explain Long-term Risk Estimation ?
Many studies have examined long-term risks associated with risk factors using traditional epidemiological methods. Framingha investigators examined well and women between 40 to 50 and followed them up to find out their overall survival and CVD free survival a1 85 years and beyond. Factors associated with survival to age 85 included female gender, lower systolic BP, IOMWI' tot01 cholesterol, better glucose tolerance, no current stoking and higher level of education attained. In presence of adverse levels of four of these factors in middle age, fewer than 5 per cent of men and 15 per cent of women survived to age 85.
In another study, men and women with a low risk factor burden (serum cholesterol < 200mg/dl, untreated BP 5 120/80 mmHg, no current smoking, no diabetes and no major ECG abnormalities) in middle age had 73-85 per cent lower visit of' CVD mortality, 40-60 per cent lower total mortality and 6-10 years greater life expectancy.
The Chicago Heart Association Detection Project in industries have shown that risk factor burden in middle age is associated with quality of life at follow-up in older age. A Finnish study also observed that cholesterol levels in middle aged men were associated with total mortality and quality of life over 39 years of follow-up.
When taken together, all these studies confirm long-term protection with low Risk factor burden and substantial long-term risks associated with adverse baseline values of CVD risk factors.
Approaches to Neuropsychological Assessment Probably the most useful model of neuropsychological interpretation is described in Reitan and Wolfson's (1993) four approaches to a
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