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Cerebrovascular disease, cognitive impairment, and dementia
  1. D Leys

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    Edited by J O’Brien, D Ames, L Gustafson, M F Folstein, E Chui. Published by Martin Dunitz, London pp406.

    The proportion of patients who will be victim of stroke or dementia is terrifying: after the age of 80 years, 1 in 5 people is affected by dementia, and 1 in 10 hav`e had a stroke or transient ischaemic attacks. The burden of stroke and dementia will continue to increase during the next 20 years in western countrie, owing to increasing life expectancy. Therefore, the economic burden of both disorders will also become a major public health issue. Stroke is an important cause of cognitive impairment and dementia. Stroke prevention, the only way to prevent vascular dementia, may also be an effective way to “prevent” Alzheimer’s disease—or at least to prevent the anticipation of its clinical onset, possibly due to the summation of vascular and Alzheimer lesions. Although the term “vascular dementia” appears in several chapters, the editors discuss two other important concepts. The first is the wide notion of “vascular cognitive impairment”, which includes a large range of severity of cognitive impairments associated with vascular lesions; behind this term is the hope of an effective prevention. The second is the interaction between Alzheimer lesions and stroke, explaining that many patients already have some degree of cognitive impairment before stroke, which may be degenerative in origin in many cases.

    The book is divided into 26 chapters, including classification and diagnosis, epidemiology and risk factors, pathophysiology, clinical features, assessment, and management. The organization of the book proceeds logically. All chapters end with the most important references. The information is made clear and is accurate. The target audience consists of all care providers who treat patients with dementia or cerebrovascular disorders. Its length and its level of details make it appropriate for residents looking for a practical knowledge, and also for trained specialists. This book will be of major interest for all those who treat patients with cognitive decline or patients at risk.

    Edited by J O’Brien, D Ames, L Gustafson, M F Folstein, E Chui. Published by Martin Dunitz, London pp406.


    • D Leys has been paid or received funds for research during the last 5 years by Sanofi- Synthelabo, AstraZeneca, Takeda, Lilly, and Servier for educational programmes, speaking, and consulting.

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