Differential Diagnosis Of Dementing Diseases

Discusses the spectrum of dementing disorders and explains their overlap, presentations, and differential diagnosis. The chapters present original data as well as material from the authors' clinical experiences. Current classification systems are evaluated and modified to better account for common presentations of dementia. Includes new material on neuroimaging, genetics, the role of inflammation in Alzheimer disease, retrophylogenesis in Alzheimer memory, and AIDS dementia.

Differential diagnosis of Alzheimer's disease, dementia and delirium, diagnostic tests in differential diagnosis, and identifying underlying conditions that can cause dementia are discussed. Covers drugs to treat cognitive symptoms, managment of agitation and behavioral symptoms, patient management, and support services.

In this special issue of Diagnostics, expert contributors have produced up-to-date research studies and reviews on various topics related to the diagnosis of dementia and cognitive impairment. The methods of the assessments discussed extend from simple neurological signs, which may be elicited in the clinical encounter, through cognitive screening instruments, to sophisticated analyses of neuroimaging and cerebrospinal fluid biomarkers of disease. It is hoped that these various methods may facilitate earlier diagnosis of dementia and its subtypes, and provide differential diagnosis of depression and functional cognitive disorders, as a prelude to meaningful interventions.

The management of Alzheimer's Disease and the related dementias is one of the major challenges to health care professionals and American society-at-large for the coming decade and the coming millennium. The rapid growth of the over-eighty-five population, the group which, as recent studies have confirmed and as many of us clinicians have long suspected, has an even higher prevalence than previously quoted of dementing disorders, is the major cause of this. We are thus challenged by, as Bernard Issacs used to call it, "the survival of the unfittest," as well as the oPtimistic approach of "bringing life to years," as John F. Kennedy said. The fact is that we, as a society, tend to confuse "treatment" and "cure" (and "prevention"). As the proceedings of the conference which this book represents emphasize, there is considerable work going on about the potential prevention of, or at least the reduction of, symptomatology in these illnesses by interventions genetically, chemIcally, and so forth. However, the more we find out, the more complicated it becomes, and the more heterogeneous Alzheimer's and the related disorders appear to be, not only in their manifestations (as clinicians have long recognized) but also in the individual initiating and underlying processes. For these reasons, absolute preventive techniques or the likelihood of an intervention which will reverse the process in a high proportion of patients, do not appear to be just around the corner.

The only guide to focus primarily on current molecular methods of diagnosis and early stage evaluation, this reference presents the latest techniques and technologies for dementia identification and evaluation, including neuropathological strategies, neuropsychological tests, biomarkers, CT, MRI, functional MRI, PET, and SPECT. Offering practical care and examination guidelines, each chapter provides findings that are particularly relevant for the assessment of disorders such as Alzheimer's disease, dementia with Lewy bodies, vascular dementia, and fronto-temporal dementia.

This text clearly presents a multitude of variables that potentially affect the results of neuropsychological tests. THe chapter authors, all noted experts in their respective fields, begin with a general discussion of neuropsychological constructs known to impact performance on neuropsychological tests, including demographics, personality, and sociocultural factors. They then present an empirical approach to assessment. They focus on the disorders under discussion (not solely the tests that might be used in diagnosis) and reflect the contributions the field has made to detecting differences in disorders that have neurological underpinnings. The disorders reviewed include dementia, HIV-related syndromes, adult seizure disorders, toxic exposure, mild to severe brain injury, and chronic fatigue syndrome.

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