The Dementias: Diagnosis, Treatment, and Research

Front Cover
Myron F. Weiner, Anne M. Lipton
American Psychiatric Pub, Aug 13, 2008 - Medical - 596 pages

Confusion. Fear. Isolation. This is the human experience of dementing illness, and it is at the heart of this practical, informative volume by a broad range of clinically grounded experts.

This book is designed to meet the needs of clinicians dealing with persons with dementing illness and to serve as an introduction to the pathophysiology of dementing illness and a resource for clinical investigators.

The giant strides in dementia research since the publication of the first edition in 1991 have generated optimism that we will soon be able to delay onset and even prevent these diseases that devastate both patients and caregivers. This third edition has been revised, updated, and expanded to cover changes in the classification, management and treatment of dementing illnesses and to give a more extensive account of basic and clinical research findings. At the same time, this remarkable volume indicates the interaction of the patient's personality, the caregiver, and the environment with the pathophysiology of dementing illnesses that creates the variety of symptoms accompanying these illnesses and impacting their treatment.

Like the second edition, this third edition has three sections, flowing from diagnosis through management/treatment to research. New to this edition are A world-class presentation on the molecular and genetic basis of Alzheimer's disease A beautifully illustrated chapter on contemporary neuroimaging Discussions of mild cognitive impairment, the frontotemporal dementias, and the dementias associated with Lewy bodies

This third edition is exceptionally valuable for addressing the day-to-day challenges of dealing effectively and humanely with persons with dementing illness. Case examples are used in the chapters on psychological/behavioral and drug management to indicate practical approaches to maintaining patients at their optimal level of function. Unlike similar texts, this volume also reviews legal and ethical issues in the care of persons with dementing illness and shows how clinicians and caregivers how to mobilize community resources. Extensive reference lists round out each chapter. The book concludes with 11 assessment guides and rating scales and an index.

Now more than ever, there is hope that advances in understanding dementing illnesses such as Alzheimer's disease will lead to their effective treatment, and ultimately to their prevention. Until then, clinicians, families, and society will continue to be faced with the challenges posed by these illnesses -- making this book a "must read" for physicians and other health care professionals, whether in training, in practice, or engaged in clinical research.

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Clinical Diagnosis of Cognitive Dysfunction and Dementing Illness
Dementing Illness as a Psychobiological Process
Medical Evaluation
Differential Diagnosis
Psychological and Behavioral Management
Drugs for Behavioral Psychological and Cognitive Symptoms
Evaluation of Cognitive Functions
Dementia Questionnaire
Mental Status Examination
Neurological Examination
Blessed Dementia Rating Scale
Washington University Clinical Dementia Rating Scale
Alzheimers Disease Assessment Scale
Neuropsychiatric Inventory Community Dwelling Version
Agitated Behavior Dementia Scale

Supporting Family Caregivers
Legal and Ethical Issues
Mobilizing Community Resources
Nursing Care for Persons with Cognitive Impairment
Structuring Environments for Persons With Cognitive Impairment
Advances in the Molecular and Genetic Basis of Alzheimers Disease
Advances in the Treatment of Alzheimers Disease
Quality of Life in Alzheimers Disease Scale
Quality of Life in LateStage Dementia QUALID Scale
Abnormal Involuntary Movement Scale AIMS

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Page 26 - A. A prominent and persistent disturbance in mood predominates in the clinical picture and is characterized by either (or both) of the following: (1) depressed mood or markedly diminished interest or pleasure in all, or almost all, activities (2) elevated, expansive, or irritable mood B.
Page 25 - The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of the day. D. There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by the direct physiological consequences of a general medical condition.
Page 213 - Practice parameter: management of dementia (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
Page 19 - A. The development of multiple cognitive deficits manifested by both (1) memory impairment (impaired ability to learn new information or to recall previously learned information) (2) one (or more) of the following cognitive disturbances: (a) aphasia (language disturbance) (b) apraxia (impaired ability to carry out motor activities despite intact motor function) (c) agnosia (failure to recognize or identify objects despite intact sensory function) (d) disturbance in executive functioning (ie, planning,...
Page 32 - Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation made by others).
Page 32 - The symptoms are not due to the direct physiological effects of a substance (eg, a drug of abuse, a medication, or other treatment) or a general medical condition (eg, hyperthyroidism).
Page 349 - A statement that the study involves research, an explanation of the purposes of the research and the expected duration of the subject's participation, a description of the procedures to be followed, and identification of any procedures which are experimental; (2) A description of any reasonably foreseeable risks or discomforts to the subject...
Page 32 - Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure.
Page 19 - B12 or folic acid deficiency, niacin deficiency, hypercalcemia, neurosyphilis, HIV infection) (3) substance-induced conditions E. The deficits do not occur exclusively during the course of a delirium. F. The disturbance is not better accounted for by another Axis I disorder (eg, Major Depressive Disorder, Schizophrenia).
Page 313 - Folstein MF, Folstein SE, McHugh PR: "Mini-Mental State": a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12:189-198 17.

About the author (2008)

Myron F. Weiner, M.D., is Professor of Psychiatry, Associate Professor of Neurology, Aradine S. Ard Chair in Brain Science, and Dorothy L. and John P. Harbin Chair in Alzheimer's Disease Research at the University of Texas Southwestern Medical Center at Dallas.

Anne M. Lipton, M.D., Ph.D., is Assistant Professor of Neurology and Psychiatry at the University of Texas Southwestern Medical Center at Dallas.

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