Dementias : Biological Bases and Clinical Approach to Treatment

To a certain extent the dementias have been forgotten diseases until just recen­ tly when they were brought to the attention of the general public and health authorities as a result of the increasing number of cases in the aging popula­ tion, especially among famous people, and because of the efforts of private foundations. The goals of the present volume are to present the dementias to health prac­ titioners, to provide some basic information on their epidemiology and biolo­ gical basis and to discuss the diagnostic and clinical problems that physicians and institutions face when caring for demented patients. This book explores the various types of dementias and is not limited to Alzheimer's disease although, as expected, more information is available and presented on this pathology. On the other hand, a few fundamental questions on dementia can only be answe­ red through a comparison of the various forms. Examples of such questions are the following: Is the loss of cerebral tissue sufficient to cause dementia? Are there thresholds or is there a continuous progression toward the irreversible development of dementia? Are there common pathways in the dementing pro­ cess? Are there common risk factors? Comparative analysis allows the common and distinctive patterns of the various dementias to be defined, ultimately lea­ ding to more focused therapeutic interventions. The dementias are presented to health practitioners to provide some basic information on the epidemiology and biological bases of the dementias. The diagnostic and clinical problems that the physician or institution faces when caring for demented patients are discussed in depth. In this book some fundamental questions on dementia are addressed, such as: Is the loss of cerebral tissue sufficient to cause dementia? Are neurotransmitter changes necessary and sufficient to produce dementia? Are there thresholds or is there a continuous progression toward the irreversible development of dementia? Are there common pathways in the dementing process? Are there common risk factors? The comparative analysis allows the common and distinctive patterns of the various dementias to be defined, which will ultimately lead to more focused therapeutic interventions. The book is based on the personal experience of the authors who are all directly involved in dementia research or clinical care of the patient. In particular, the main forms of dementia (Alzheimers disease, vascular dementia, Lewy body disease, frontotemporal dementia) are treated as separate chapters by experts in the field. Some chapters are devoted to the care of the patient, which means interventions that provide care for patients at home or in an institution. The economical burden of the illness for the family and the healthcare system and the ethical aspects are also addressed.

The book contains black-and-white illustrations.

Front Matter....Pages I-XI Dementias, the Dimension of the Problem: Epidemiology Notes....Pages 1-18 The Biological Basis of Dementias....Pages 19-50 Classification and Diagnosis of Dementias....Pages 51-76 Alzheimer’s Disease....Pages 77-101 Lacunes in — the Knowledge of — Vascular Dementia....Pages 103-135 Dementia with Lewy Bodies....Pages 137-149 Frontotemporal Dementia....Pages 151-171 Pseudodementia....Pages 173-194 Neuropsychiatric Symptoms in Dementia Patients....Pages 195-221 Non-Cognitive Symptoms and Alterations in Demented Patients....Pages 223-231 Pharmacotherapeutic Approach to the Treatment of Alzheimer Disease....Pages 233-251 Non-Pharmacological Treatment of Alzheimer’s Disease and Related Disorders....Pages 253-272 GENTLECARE: the Prosthetic Life Care Approach to Providing Dementia Care at Home or in Institutions....Pages 273-285 Economics of Dementia....Pages 287-296 Ethical Problems in Caring for Demented Patients....Pages 297-308 The population of both the developed and developing world is aging due to the longer life expectancy and declining fertility.