Dementia: Current Perspectives in Research and Treatment synthesizes a broad range of scientific, medical and sociological research and provides an encyclopaedic introduction for anyone interested in learning about and managing dementia for professional and personal reasons. All 12 chapters are written in an engaging way for both general readers and a professional clinical psychology audience. The tone is reassuring and hopeful for anyone worried about dementia as an existential threat. Misconceptions and stigma are carefully challenged. At the same time there is no downplaying of the severity of neurocognitive decline and its impact on memory, language, reasoning and visual-spatial processing.
The first two chapters define and establish the significance of the topic. Chapter 1, ‘What is dementia?’, clarifies what is meant by dementia and how understanding has changed since it was first identified. Chapter 2, ‘Is dementia part of the normal ageing process?’, questions ideas about dementia as an inevitable part of ageing and summarises a wide range of risk factors.
Chapters 3 through 6 offer a comprehensive discussion of the strengths and weaknesses of current clinical approaches, whilst highlighting challenges, including the length of time needed to reach a diagnosis. Chapter 3, ‘Forms of dementia’, describes the varying forms that dementia takes. Chapter 4, ‘Assessment’, reviews the methods used to assess someone who is showing signs of significant cognitive impairment. Chapter 5, ‘Diagnosis’, considers the processes of elimination and testing leading to a diagnosis. Chapter 6, ‘Treatment’, details drug therapies and psychological interventions. All four chapters offer much more than a list of clinical classifications. Neglected areas are highlighted, for instance how visual-spatial processing problems can be overshadowed by a focus on memory loss. Classifications are clarified, such as how dementia is classed as a neurocognitive disorder (NCD) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) but the term ‘dementia’ is still widely used by clinicians and patients.
The next four chapters are shorter and focus on new areas of discussion. Chapter 7, ‘Regulating emotions’, reflects on the internal struggle in people living with dementia between denial versus acknowledging and talking about their experiences. Ideas about reducing and regulating emotional distress are explored with reference to the author’s work on nostalgia-based interventions. Chapter 8, ‘Intellectual development disorder and dementia’, illuminates an under-researched aspect of dementia. Chapter 9, ‘The role of the carer’, summarises issues to be considered around care, whilst Chapter 10, ‘Cross-cultural issues’, considers the importance of culture and language for those with dementia and the need for culturally sensitive dementia services.
The final two chapters look to the future. Chapter 11, ‘Future directions’, focuses on the medical advances and areas that are attracting more attention, such as telemedicine, smart homes and dementia-friendly workplaces. In Chapter 12, ‘Postlude’, the impact of the Covid-19 pandemic on people living with dementia is scrutinised and gaps in health care are exposed.
Overall, the book can be read as an informed conversation with a specialist who addresses medical and social topics. Each chapter ends with a succinct summary. Uncertainty is addressed, for example, in the mission to make sense of the complex interactions between genes, environment and lifestyle. The author acknowledges the challenges of determining correlations or causal relationships, such as whether loneliness is a risk factor for dementia, or whether social withdrawal is a reaction to increasing cognitive impairment. He also considers the lack of clarity about how to assess subjective cognitive decline (SCD) and mild cognitive impairment (MCI), and simultaneously manage the possibility that they may develop into dementia or may provoke unnecessary worry and fear. Occasional paragraphs are given over to dry debunking of bogus claims and news headlines about dietary and lifestyle choices that ‘cause’ or ‘cure’ dementia. Readers are signposted to ‘behind the headlines’ websites that ‘reveal the scientific truth hidden behind the media gloss’ (28).
Perhaps most importantly, the book keeps people living with dementia in full sight as unique individuals with a sense of self. They are not reduced to a set of symptoms. A strong case is made successfully for greater commitment to better post-diagnostic support for people living with dementia and their carers. Better support would help them to live with the purpose and dignity they deserve. Hopefully, this book helps build the political momentum needed to make this happen.
