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Dementia Handbook
  1. PETER NESTOR

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    Dementia Handbook. By richard j harvey, nick c fox, andmartin n rossor. (Pp 116, 19.95). Published by Martin Dunitz Ltd, London, 1999. ISBN 1-85317-753-9.

    Clinically, dementia is an unusual area in that it cannot be pigeon holed into any single specialisation. Gerantologists, neurologists, and psychiatrists all have a part to play in the medical management; while the contribution of neuropsychology, a non-medical discipline, cannot be underestimated. Consequently books which offer a comprehensive patient oriented clinical approach to the subject can be hard to find.

    The Dementia Research Group of which the authors are members certainly have the credentials to effect such a synthesis and this book manages to provide a brief but useful synopsis spanning the various fields as well as some areas (for example, support services) usually absent from any medical text. Recent developments in diagnosis and treatment of the dementias have made past algorithms obsolete; especially diagnostic, where the philosophy of the “standard” CAT, thyroid and B 12 assays, and a syphilis test was to exclude rather than establish a diagnosis. In this sense the book is also timely with handy summaries of major categories as well as rare causes of dementia. There are also useful prescribing guidelines for the new antidementia drugs.

    In attempting to squeeze such a comprehensive checklist into a small space there is the risk of becoming feckless. Thus we learn in the “blood tests” section that HIV testing is indicated “in suspected HIV infection”. Likewise such brevity may become overly dogmatic: the reader is advised that echocardiography (oddly listed as a neurophysiological test) should be performed in suspected vascular dementia. But these are only pedantic criticisms for a book which should find a place in the clinic as a practical pocket reference.

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