Dementia: Presentations, Differential Diagnosis, and Nosology
http://www.100md.com
《新英格兰医药杂志》
The scope and content of this book are aptly indicated by the title. However, the order of the topics inverts the prevailing focus, which is nosology. Above all, this book critically examines the current state of the classification and diagnosis of dementia, espousing the concept that dementia syndromes are more accurately depicted as spectral composites than as singular, discrete clinicopathological entities. This overarching theme resonates with another emerging view of degenerative dementias that emphasizes the interacting components of pathologic processes that involve abnormal protein folding, abnormal accumulations of proteins, or both.
The first of the five parts of the book provides an enlightened conceptual overview of dementia as a clinically operational construct and should be required reading for any student of dementia. The second part covers Alzheimer's dementias, reflecting a common theme of clinical and neuropathological heterogeneity in what has come to be popularized, more out of convenience than ignorance, as a single disease entity. The third part addresses vascular and subcortical dementias, with an emphasis on the presentations of vascular dementias and their relation to Alzheimer's disease. The fourth part presents both a cogent historical discussion and recent clinical and neurobiologic data that illuminate the nebulous subject of depressive dementia. In the final part, a review of pharmacologic and nonpharmacologic treatments for Alzheimer's disease is followed by the editors' reflective synthesis of their own and their contributors' offerings.
The chapters are generally well written and follow a common format of ending with clinical conclusions. This format helps to maintain a general clinical orientation that balances several chapters, of which Emery is an author, that stand apart from the others. Emery's contributions are more theoretical and thought provoking, though laden with idiosyncratic and labyrinthine prose. The concept of "retrophylogenesis," which she introduces, expands on the ontogenic theory of retrogenesis advanced by Reisberg in postulating that stages of decline in Alzheimer's disease inversely reflect evolutionary stages of human adaptation.
Comprehensive works on dementia are typically written by one, two, or many authors. In the case of those with one or two authors, uniformity and coherence may be partially offset by limited expertise across a broad range of topics. When there are many authors, although the work may be generally more authoritative, redundancy or inconsistency may contravene that authority. This book treads the uncommon ground of attempting to wed the virtues of the two approaches — and largely succeeds. Given the general theme of spectrally related dementia syndromes, it is perhaps an oversight that only two paragraphs in the book are devoted to dementia in Parkinson's disease, the second most common neurodegenerative disorder in adults. Despite this and other minor omissions, the book is a forward-thinking contribution to the field of dementia and is commendable for its goal of striving beyond overly simplistic, formulaic conventions. It would be well placed on the library shelf of the curious and contemplative cognitive clinician.
Daniel Kaufer, M.D.
University of North Carolina School of Medicine
Chapel Hill, NC 27599
kauferd@glial.med.unc.edu(Second edition. Edited by)
The first of the five parts of the book provides an enlightened conceptual overview of dementia as a clinically operational construct and should be required reading for any student of dementia. The second part covers Alzheimer's dementias, reflecting a common theme of clinical and neuropathological heterogeneity in what has come to be popularized, more out of convenience than ignorance, as a single disease entity. The third part addresses vascular and subcortical dementias, with an emphasis on the presentations of vascular dementias and their relation to Alzheimer's disease. The fourth part presents both a cogent historical discussion and recent clinical and neurobiologic data that illuminate the nebulous subject of depressive dementia. In the final part, a review of pharmacologic and nonpharmacologic treatments for Alzheimer's disease is followed by the editors' reflective synthesis of their own and their contributors' offerings.
The chapters are generally well written and follow a common format of ending with clinical conclusions. This format helps to maintain a general clinical orientation that balances several chapters, of which Emery is an author, that stand apart from the others. Emery's contributions are more theoretical and thought provoking, though laden with idiosyncratic and labyrinthine prose. The concept of "retrophylogenesis," which she introduces, expands on the ontogenic theory of retrogenesis advanced by Reisberg in postulating that stages of decline in Alzheimer's disease inversely reflect evolutionary stages of human adaptation.
Comprehensive works on dementia are typically written by one, two, or many authors. In the case of those with one or two authors, uniformity and coherence may be partially offset by limited expertise across a broad range of topics. When there are many authors, although the work may be generally more authoritative, redundancy or inconsistency may contravene that authority. This book treads the uncommon ground of attempting to wed the virtues of the two approaches — and largely succeeds. Given the general theme of spectrally related dementia syndromes, it is perhaps an oversight that only two paragraphs in the book are devoted to dementia in Parkinson's disease, the second most common neurodegenerative disorder in adults. Despite this and other minor omissions, the book is a forward-thinking contribution to the field of dementia and is commendable for its goal of striving beyond overly simplistic, formulaic conventions. It would be well placed on the library shelf of the curious and contemplative cognitive clinician.
Daniel Kaufer, M.D.
University of North Carolina School of Medicine
Chapel Hill, NC 27599
kauferd@glial.med.unc.edu(Second edition. Edited by)