Like previous editions, the third edition of Dementia provides wide-ranging coverage of all aspects of the dementias, and is destined to become another classic text. The first part covers diagnosis, assessment, investigations and management of dementia in general, and includes structural and functional brain imaging, neuropsychological and neuropsychiatric aspects of dementia, management and service delivery. Parts two to seven cover Alzheimer's disease, vascular dementia, dementia with Lewy bodies and Parkinson's disease, focal dementias and other less common dementias, in addition to a new section on mild cognitive impairment and the potential therapeutic opportunities in this area. Written by leading researchers in their fields, each chapter present a comprehensive overview of the area in addition to recent advances in the areas of basic science and applied research.
The book follows the same format as the second edition but several new topics have been introduced. A chapter on epidemiology reminds us that the demographic shift to older populations continues, with concomitant increase in absolute numbers of older people with dementia throughout the world, but especially in developing countries. Several fascinating chapters on services available in developing countries are a stark reminder that many do not currently have the resources to deal with this explosion in need, and that traditional (female) carers in many societies are increasingly becoming less willing or are financially unable to look after their elderly relatives. Another chapter presents a very moving personal account by the husband of a woman with early-onset Alzheimer's disease, which sums up not only the ‘terrible pain and fierce anger’ but also the tremendous amount of love and humanity shown by committed carers. Unfortunately, many older people with dementia do not have this level of support. They still face abuse in generic care settings and in their own homes, and the ageism that exists in many societies serves as a major obstacle to improving the care that people with dementia receive. With the increasing numbers of people with dementia, and fewer younger people available to provide care, these issues will demand more attention in the future.
In this edition of Dementia there has been a swing towards the psychosocial aspects of dementia, and service development. There is a particularly good description of how speech and language therapists can help us to improve our communication with people with dementia. These skills will become increasingly necessary in the next few decades as more people with dementia are cared for in non-specialist settings. The matter of how care is provided for people with dementia in mainstream settings is an area that is currently receiving more attention from policy-makers and researchers. Hopefully, there will be sufficient material to warrant a chapter in the next edition as this kind of research evidence will be essential to decision-makers attempting to provide good-quality care for the increasing numbers of people with dementia.
Like its predecessors, this edition of Dementia is an admirable piece of work that is a comprehensive and cutting-edge reference book, while being easy to read and accessible to readers from different professional backgrounds. No department that is providing healthcare to the elderly should be without a copy.
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