Abstract
The third edition of this American book that was first published in 1991 maintains the high standards previously set. Primarily written for clinicians, it covers all of the important clinical areas of dementia care. These include assessment, diagnosis, investigations, pharmacological and non-pharmacological management, carer issues and ethical/legal issues. Throughout the book the writing is clear, concise and relatively free of jargon. Although multiauthored, seven of the 15 chapters are cowritten by one of the editors, Myron Weiner. His chapters, aided by case vignettes, particularly convey sensitivity to the human suffering that occurs with dementia and the impact that it has upon family and friends. His chapter on the psychobiological process of dementia is a highlight in this regard.
The neuroimaging chapter written by Gene Alexander and Eric Reiman is new to the third edition. This is an excellent chapter that provides a state of the art appraisal of the major structural and functional neuroimaging techniques used in dementia investigation but at the same time gives easy to understand explanations of how the various techniques work. It also covers some of the new techniques such as Magnetic Resonance Spectroscopy and Functional Magnetic Resonance Imaging that are likely to play an important role in dementia investigation in years to come.
Another enjoyable chapter by Paul Chafetz and Kevan Namazi deals with structural environments for persons with cognitive impairment and gives clinicians plenty of ideas on an often neglected but important topic.
There are no weak chapters though some do not quite live up to expectations. For example, the chapter on drug treatments in dementia, while covering all of the major treatments of behavioural, psychological and cognitive symptoms with a thorough review of the published literature, fails to give clear guidance to the clinician about best practice. There are also some inconsistencies between dosages mentioned in the text and those in the tables and there is an inadequate coverage of the risks of using antipsychotic drugs in dementia with Lewy bodies.
The last two chapters that examine research advances on the molecular and genetic basis of Alzheimer's disease and treatments of Alzheimer's disease are really the only non-clinical chapters in the book. Both chapters are superb, only being hampered because they are inevitably a few years behind current knowledge. The 12 appendices contain copies of structured pro forma examinations and standardized scales used in dementia assessment, though surprisingly the Folstein Mini-Mental State Examination is not included. These will be handy for many clinicians.
I recommend this book for clinicians and trainees (medical and non-medical) though researchers will not find that it covers relevant issues in sufficient detail.