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Doody's Review ServiceReviewer: Eric Gausche, MD (University of Illinois at Chicago College of Medicine)
Description: With this book, the authors provide a resource for clinicians who will be caring for the "more than 5 million individuals with memory loss...whether their degree is in medicine, psychology, nursing, social work, or therapies." They succeed admirably, covering the basics of dementia evaluation, differential diagnosis, treatment (pharmacological and nonpharmacological), and psychosocial issues.
Purpose: The purpose is twofold. First, "Primary care providers, nurses, psychologists, and students will find this book a very practical, clinically oriented guide that helps them know what to do when sitting in the office with a patient complaining of memory loss." Second, "Specialists...will find this book a wealth of up-to-date information regarding the latest diagnostic tools and treatments for their patients with memory loss." With the aging of the population, the recognition and treatment of dementias will increasingly come to be a set of essential skills for any clinician. Overall, this book meets its first objective admirably. It almost meets its second objective, but overall the book appears more useful for generalists than specialists.
Audience: Although the book is written for both generalists and specialists, students and experienced clinicians, the more appropriate audience appears to be students and generalists, rather than neurological or neuropsychiatric specialists. Both authors are authorities in the area of neurodegenerative dementias.
Features: The book covers the daunting subject of the evaluation, differential diagnosis, and treatment of patients with dementing illnesses. All chapters start with a point-by-point summary of the content, rapidly orienting readers. Section II on several of the main dementias is excellent. A topic that could have been better covered is that of rapidly progressive dementia, which has a different differential diagnosis and workup beyond that of dementias with a more insidious onset. The book addresses this topic once, in Box 11.2: Differential Diagnosis of Rapidly Progressive Dementias, but there is no real discussion. A feature that some will find useful, but I found distracting, is the frequent use of boxes set apart from the main text. Take, for example, Chapter 12: Other Disorders. In this chapter, which is 12 pages long, there are four such boxes. Two of them are completely appropriate (Box 12.3: Common Classes or Properties of Medication Causing Cognitive Dysfunction and Box 12.4: Contact Sports that Have Been Associated with Multiple Concussions), as they are long lists that are not easy to integrate into the body of the text. However, the other two boxes serve to disengage readers from the flow of the text, and the information they present could have been easily incorporated: 12.1: Rule of Thumb (a description of the old cliche that poor insight into memory problems is indicative of dementia of the Alzheimer's type) and 12.2: Pseudodementia (a paragraph on the concept of depressive pseudodementia). These are, however, nitpicks about a book that is, overall, well written and useful. Another potential shortcoming is the authors' laudable ambition to engage readers at all levels of expertise. The need to cover sufficient background material to engage students and generalists leaves less room for material more pertinent for specialists and subspecialists.
Assessment: This is a very good addition to the books on dementias. It is written in a clear style, albeit with some distracting elements in the layout. It will be very useful to readers who are students or generalists, but neurological or neuropsychiatric specialist may want more detail than this book provides.