Book Review
General Psychiatry
Dementia: Presentations, Differential Diagnosis, and Nosology. 2nd ed. V Olga B Emery, Thomas E Oxman, editors. Baltimore (MD): Johns Hopkins University Press; 2003. 533 p. US$99.95.
Reviewer
rating*: Excellent
Review by: Matthew Robillard, MD
North York, Ontario
This book’s thorough and current discussion of many important aspects of dementia is a major contribution to dementia research. In this new edition, a distinguished group of medical authorities from all over the world—including many who have done seminal research in the field—discuss the spectrum of dementing disorders and explain their overlap, presentations, and differential diagnosis. They present original data as well as material from their clinical experiences. Current classification systems are evaluated and modified to better account for common dementia presentations.
Thoroughly revised, updated, and expanded, this second edition includes new material on neuroimaging, genetics, the role of inflammation retrophylogenesis (which is a new memory framework), and AIDS dementia. In addition, each chapter includes a new section describing clinical applications.
The authors have performed a valuable service in documenting the pitfalls in our current understanding of dementia. This book fulfills the purpose for which it was written and will interest researchers, academics, psychologists, neurologists, and psychiatrists.
The authors of many chapters are well recognized for their academic contributions. Dr T Oxman, one of the editors, has written a chapter entitled, “The Spectrum of Dementias: Construct and Nosologic Validity.” I found this chapter well written and interesting. At the end, Dr Oxman identifies 4 potentially salient areas for advancing the field of dementia research, in terms of construct and experimental validity. They are the relation of dementia to normal aging changes, attention to confounding variables, functional impairment and quality of life, and biological markers in dementia. Dr O Emery, the other editor, has written a chapter entitled “Retrophylogenesis of Memory in Dementia of the Alzheimer Type: a New Evolutionary Memory Framework.” This chapter offers a theoretical and empirical discussion of memory deficits of the Alzheimer type. Data are presented suggesting that dementia of the Alzheimer type (DAT) involves a process she terms “retrophylogenesis” because the last memory structures to evolve in phylogenesis are the first to deteriorate in dementia. A new 3-tiered evolutionary memory framework is introduced, wherein each tier originates in a different period in phylogenetic history: motor memory, emotional memory, and neocortical memory. The concept “retroontogenesis” is introduced in the context of neocortical memory in DAT. This chapter has been thoroughly researched, and the number and quality of the references indicates that much serious thought has gone into its writing.
For many people, including myself, the 37-page chapter discussing approaches to treating dementing illness is particularly important and interesting. Brief descriptions of cognitive enhancers, antidepressants, antipsychotics, anticonvulsants, benzodiazepines, and other anxiolytics are included. However, clinicians interested in learning more about how to decide when to start treatment, how to select a particular agent, how and when to switch agents, and how to decide about the length of treatment will have to look elsewhere.
This is a reference book, and the style is formal and scholarly. I liked the brief description of key topics and ideas at the end of each chapter. The book’s mostly grey cover maps out a portion of the galaxy or entity wherein there is an opportunity to explore and to learn more: I congratulate Mr Holman, the designer of the book jacket, on his style and creativity.
I continue to reflect on whether the price of any book can be considered “ reasonable.” Certainly, this book will have different importance for different people, and certainly, the relevance of price varies with one’s financial position. The book is clearly an excellent reference text for those exploring both the uncharted areas of research and some of the clinical aspects of dementia.
*Reviewer
Rating Scale/ Échelle d’évaluation du réviseur
Excellent / Excellent
Very Good / Très bon
Good / Bon
Fair / Passable
Not recommended / Pas recommandé
|
