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Doody's Review ServiceReviewer: David O. Staats, MD (University of Oklahoma Health Sciences Center)
Description: This multiauthored monograph chronicles how changes in brain blood vessels affect cognition and cause dementia and other related syndromes. It is a brilliant synthesis of a complicated topic, drawing together knowledge and recent discoveries from a wide variety of disciplines.
Purpose: The purpose is to review the knowledge of vascular cognitive impairment and provide practical suggestions for evaluation and treatment of these conditions. Because vascular dementia is the second leading cause of dementia, this book is urgently needed. The authors accomplish their objectives handsomely.
Audience: The audience includes neurologists, gerontologists, geriatricians, and other physicians who evaluate and care for demented persons.
Features: The 18 chapters are divided among three sections: diagnosis, pathophysiology, and treatment. Excellently reproduced imaging studies and histopathology slides enhance all of these sections. The sections link together what is known about how the brain processes information in neural networks (how the brain works) with how vascular abnormalities interrupt these processes (how diseases work). This, in turn, leads to diagnostic methods and treatments.
Assessment: This is a major contribution to the field. It sorts out in clear fashion a very tangled literature. In the process, it points out just where future research is needed. Methodological issues of such research and the profound implications of epidemiological studies (vascular disease starts early and causes cognitive changes in midlife) are emphasized. In addition, the book provides clear outlines of the approach to differential diagnosis and management of these patients, including caregiver support. Finally, the links of heart disease to both vascular cognitive impairment and Alzheimer's disease are discussed. The excellent organization and editing of this book, its careful elaboration of complex concepts, and the practical application of this synthesis give rise to a first-rate work. This much-needed book deserves a wide readership.