Dementia (eBook)

Mario Maj is Professor o+A1191f Psychiatry at the Primo Policlinico Universitario in Naples, Italy. Maj has been President of the Italian Psychiatric Association; President of the Italian Society of Biological Psychiatry; Secretary-General of the Association of European Psychiatrists; Editor of European Psychiatry and World Psychiatry. He became President of the Association of European Psychiatrists in January 2002 and of the World Psychiatric Association in 2008. Norman Sartorius is a psychiatrist and professor. He previously served as a director of the World Health Organization's Division of Mental Health. He has also been a former president of the World Psychiatric Association and of the European Psychiatric Association.

VOLUME 3 Dementia Second Edition 3
Contents 7
List of Review Contributors 13
Preface 15
CHAPTER 1 DEFINITION AND EPIDEMIOLOGY OF DEMENTIA 17
Definition and Epidemiology of Dementia: A Review 17
COMMENTARIES 50
1.1 The Continuing Evolution of Dementia Epidemiology 50
1.2 Dementia: Hope for the Future 52
1.3 Dementia: Much Information, Many Unanswered Questions 55
1.4 Vascular Factors and Dementia 58
1.5 Dementia: Known and Unknown 61
1.6 Dementia: a Public Health Emergency and a Scientific Challenge 63
1.7 Dementia: Plenty of Questions Still to Be Answered 66
1.8 Rates and Risk Factors for Dementia: Evidence or Controversy? 68
1.9 Dementia: the Public Health Challenge 71
1.10 Definition and Epidemiology of Dementia: Some Issues that Need Clarification 73
1.11 Dementia: the Challenge for the Next Decade 75
1.12 Recent Progress in the Definition and Epidemiology of Dementia 78
1.13 Dementia: Some Controversial Issues 80
1.14 Is the Prevalence Rate of Alzheimer’s Disease Increasing in Japan? 82
CHAPTER 2 CLINICAL DIAGNOSIS OF DEMENTIA 85
Clinical Diagnosis of Dementia: A Review 85
COMMENTARIES 132
2.1 The Value of Inclusive Diagnostic Thinking and Appreciating Developmental Variance 132
2.2 Reflections on Retrogenesis 134
2.3 Dementia: Diagnosis, Progression and Retrogression 136
2.4 Staging of Severe Alzheimer’s Disease and the Concept of Retrogenesis: Doors to be Opened for Research and Clinical Practice 139
2.5 When Diagnosis is Certain, Functional Scores are Robust and Recommendable Markers of the Progression of Alzheimer’s Disease 141
2.6 Findings with the Aid of Functional Assessment Staging (FAST) 143
2.7 Two Decades of Longitudinal Research in Alzheimer’s Disease 146
2.8 Diagnosing Dementia: the Need for Improved Criteria 148
2.9 Pitfalls in Diagnosing Alzheimer’s Disease 151
2.10 Evaluating the Performance of Measures to Assess Dementia 152
2.11 Dementia as a Diagnostic Entity 155
CHAPTER 3 NEUROPSYCHOLOGICAL AND INSTRUMENTAL DIAGNOSIS OF DEMENTIA 159
Neuropsychological and Instrumental Diagnosis of Dementia: A Review 159
COMMENTARIES 182
3.1 Improving Diagnosis of Dementia 182
3.2 The Contribution of Neuropsychology to the Assessment of Dementia Syndromes 185
3.3 Neuropsychological and Instrumental Diagnosis of Dementia: the Evidence 187
3.4 Some Clinical Aspects and Research Issues in the Neuropsychological Assessment of Dementia 189
3.5 The Role of Cognitive and Functional Evaluation in the Care of Patients with Dementia 192
3.6 Evaluating the Cognitive Changes of Normal and Pathologic Aging 195
3.7 Alzheimer’s Disease and Other Degenerative Dementias: Need for an Early Diagnosis 198
3.8 Neuropsychological and Instrumental Diagnosis of Dementia in a Clinical Context 200
3.9 Neuropsychological Tests that are Helpful to the Etiological Diagnosis of Dementia 203
3.10 The Importance of an Early Diagnosis in Alzheimer’s Disease 205
3.11 When Should We Use Which Diagnostic Tools? 209
3.12 Factors Affecting Diagnosis in Dementia 211
CHAPTER 4 PHARMACOLOGICAL TREATMENT OF DEMENTIA 215
Pharmacological Treatment of Dementia: A Review 215
COMMENTARIES 263
4.1 Alzheimer’s Disease is Treatable 263
4.2 Treatment of Dementia: Where Do We Go from Here? 267
4.3 The Future of Alzheimer’s Pharmacotherapeutics 269
4.4 Outcome Measures and Ethical Issues in the Pharmacotherapy of Alzheimer’s Disease 272
4.5 From Bench to Bedside: How to Treat Dementia 275
4.6 Some Limitations in the Drug Treatment of Alzheimer’s Disease 278
4.7 Issues Regarding the Pharmacotherapy of Dementia 282
4.8 Treatment of Cognitive and Non-cognitive Disturbances in Dementia 285
4.9 Are There Concerns about the ‘‘Real World’’ Effectiveness and Safety of Medications for Alzheimer’s Disease? 288
4.10 Phytoneuropsychotropics in Alzheimer’s Disease: Treatment and/or Prevention 291
CHAPTER 5 PSYCHOSOCIAL INTERVENTIONS FOR DEMENTIA 295
Psychosocial Interventions for Dementia: A Review 295
COMMENTARIES 324
5.1 Psychosocial Dimensions of Dementia Care 324
5.2 First Experience, then Evidence, then Possibly New Criteria 328
5.3 The Development of Cognitive Neurorehabilitation for Alzheimer’s Disease 330
5.4 Psychosocial Interventions and Behavioural Treatments for Dementia 333
5.5 The Need for Greater Specificity in Psychosocial Interventions 335
5.6 Psychosocial Interventions in Dementia: the Nature and Focus of Intervention, Outcome Measurement and Quality of Life 338
5.7 General Comments on Psychosocial Interventions for Dementia 341
5.8 Changing Therapeutic Paradigms 343
5.9 Psychosocial Interventions in Dementia: Attitudes, Approaches, Therapies and Quality of Life 346
5.10 The Importance of Touch and Contact 348
5.11 The Need to Improvise and Look for Evidence 350
5.12 The Need for Psychosocial Interventions in Dementia 353
5.13 Sharing and Supporting Families with Dementia 354
CHAPTER 6 COSTS OF DEMENTIA 357
Costs of Dementia: A Review 357
COMMENTARIES 386
6.1 Dementia: the Challenges for Economic Analysis 386
6.2 Costs of Dementia: More Questions than Answers 388
6.3 Toward the Economics of Dementia 391
6.4 A Cautionary Commentary on Costs of Dementia Studies 394
6.5 Costs of Dementia: Valuable Information for Economic Evaluations 396
6.6 Cost of Illness Study in Dementia: a Comment 398
6.7 Dementia: Whose Burden is it Anyway? 400
Acknowledgements for the First Edition 405
Index 407