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Severe Dementia
John Wiley and Sons Ltd, April 2006, Pages: 260
Severe dementia has not had a high profile in the clinical literature as until recently prognosis was poor and there were few beneficial interventions. With the recent licensing of memantine, clinicians finally have a drug option that will effect disease progression. Dementia brings a huge burden of care and is expensive in health economics terms, and severe dementia is even costlier due to higher rates of institutionalization. A recent study indicated that patients with severe dementia required an additional 41+ hours of care per week. Now that more can be done at this stage of the disease to lessen or manage its effects, clinical interest has increased and a text on clinical management is needed by psychiatric and geriatric medicine practitioners. Introductory chapters on the Differential Diagnosis, Neurochemistry and Molecular Pathology of severe dementia set the scene for the clinical discussion. These are followed by detailed clinical chapters on Cognitive Function, Depression, Physical Effects, Staging and Function. All therapeutic interventions are then discussed, including chapters dedicated to Memantine, Anticholinesterases, Neuroleptics and Nonpharmacological treatment. The final chapters review the social and economic aspects of dementia care, including family involvement, person-centered care, palliative care, ethics and health economics. Severe Dementia summarises current knowledge of pathophysiology and provides a detailed guide to all aspects of the clinical management of these patients.
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