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Clinical diagnosis and management of Alzheimer's disease
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Book reviews/Clinincal Neurology and Neurosurgery 98 (1996) 265 266
Neuropsychiatry in Old Age, by C. Stefanis and H. Hippius, 1996, Hogrefe & Huber Publishers, Seattle, USA, 171 pages, US$ 32, ISBN 0-88937-137-7 This book is the third volume in the series Psychiatry in Progress, and summarises the proceedings of a scientific meeting held in Rhodes, Greece, in April 1994. The aims were, as the editors explain in the preface of this book, 'both to outline the current state of scientific knowledge on the biology of ageing and to address the major issues relating to neuropsychiatric disorders in the elderly'. This statement is at least exaggerated and misleading, since the book only contains a hotch-potch of individual and unrelated research papers, mostly followed by a discussion among the participants. Five chapters deal with fundamental work on ageing of the nervous system (the role of calcium, and neurone-glia interactions), and Alzheimer's disease (neuropathology and molecular genetics). The next seven chapters are more clinically oriented, and deal with epidemiology, psychological testing, and pharmacological therapy. There is a final chapter on ethics and medical decisions making in demented patients. It is a readable book which may be of interest for those working in the field of psychogeriatrics. J. De Keyser, M.D., Ph.D. Department of Neurology University Hospital Groningen Groningen, Netherlands
Clinical Diagnosis and Management o f Alzheimer's Disease, by Serge Gauthier (editor), Martin Dunitz Publ., London, 1996, 384 pages, £69.95, ISBN 185317-308-8 This is a multiauthor book edited by Serge Gauthier. It is well organised and divided into six parts. The information is clearly given and illustrated in tables and schemes. The morphological part lacks some illustration. After a short introduction (Part I) a lot of attention is paid to the clinical diagnosis (Part II). The first chapters of Part II are clearly written and balanced. Chapters 6 (imaging) and 7 (electrophysiology) appear to offer a critical review, but lack some self criticism. CT and MRI play a role in excluding other disorders in the diagnostic workup in dementia, but at the time they have no role in a positive way. The same holds for other imaging techniques as SPECT and PET. For research purposes and the development of drugs, these imaging techniques are certainly very useful. For the electrophysiology the limitations are not clearly given. With regard to its clinical use for diagnostic work-up, EEG and other tests are seldom of use. In Part III the natural evolution is well described. But the strength of this book is in the second half where in Part IV, the medical management, and in Part V, the community and institutional management is extensively discussed. The medication section gives too much attention to the tacrine story, but that is my personal view. The last section (Part VI) addresses the ethical and legal issues, which is often overshadowed by the medical and biological facts. There is still no answer for Alzheimer's disease, but there are enough entrances to develop further strategies leading to solutions to improve quality of life of patients and family. There is hope for the future. This book will certainly be of help for all persons, medical, but also paramedical, working with patients with Alzheimer's disease.
Prof. Dr. R.A.C. Roos Department of Neurology, K5Q Leiden University Hospital Leiden, Netherlands
Book reviews/Clinincal Neurology and Neurosurgery 98 (1996) 265 266
Neuropsychiatry in Old Age, by C. Stefanis and H. Hippius, 1996, Hogrefe & Huber Publishers, Seattle, USA, 171 pages, US$ 32, ISBN 0-88937-137-7 This book is the third volume in the series Psychiatry in Progress, and summarises the proceedings of a scientific meeting held in Rhodes, Greece, in April 1994. The aims were, as the editors explain in the preface of this book, 'both to outline the current state of scientific knowledge on the biology of ageing and to address the major issues relating to neuropsychiatric disorders in the elderly'. This statement is at least exaggerated and misleading, since the book only contains a hotch-potch of individual and unrelated research papers, mostly followed by a discussion among the participants. Five chapters deal with fundamental work on ageing of the nervous system (the role of calcium, and neurone-glia interactions), and Alzheimer's disease (neuropathology and molecular genetics). The next seven chapters are more clinically oriented, and deal with epidemiology, psychological testing, and pharmacological therapy. There is a final chapter on ethics and medical decisions making in demented patients. It is a readable book which may be of interest for those working in the field of psychogeriatrics. J. De Keyser, M.D., Ph.D. Department of Neurology University Hospital Groningen Groningen, Netherlands
Clinical Diagnosis and Management o f Alzheimer's Disease, by Serge Gauthier (editor), Martin Dunitz Publ., London, 1996, 384 pages, £69.95, ISBN 185317-308-8 This is a multiauthor book edited by Serge Gauthier. It is well organised and divided into six parts. The information is clearly given and illustrated in tables and schemes. The morphological part lacks some illustration. After a short introduction (Part I) a lot of attention is paid to the clinical diagnosis (Part II). The first chapters of Part II are clearly written and balanced. Chapters 6 (imaging) and 7 (electrophysiology) appear to offer a critical review, but lack some self criticism. CT and MRI play a role in excluding other disorders in the diagnostic workup in dementia, but at the time they have no role in a positive way. The same holds for other imaging techniques as SPECT and PET. For research purposes and the development of drugs, these imaging techniques are certainly very useful. For the electrophysiology the limitations are not clearly given. With regard to its clinical use for diagnostic work-up, EEG and other tests are seldom of use. In Part III the natural evolution is well described. But the strength of this book is in the second half where in Part IV, the medical management, and in Part V, the community and institutional management is extensively discussed. The medication section gives too much attention to the tacrine story, but that is my personal view. The last section (Part VI) addresses the ethical and legal issues, which is often overshadowed by the medical and biological facts. There is still no answer for Alzheimer's disease, but there are enough entrances to develop further strategies leading to solutions to improve quality of life of patients and family. There is hope for the future. This book will certainly be of help for all persons, medical, but also paramedical, working with patients with Alzheimer's disease.
Prof. Dr. R.A.C. Roos Department of Neurology, K5Q Leiden University Hospital Leiden, Netherlands