Sense And Senility The Neuropathology Of The Aged Human Brain

nly two things are certain in life, one is that all of us will inevita Obly grow older, the other is that at some point during or at the end of this process we shall die. Inherent to the passage of time is a deterio ration in the structural and functional integrity of our bodies, this pro gressing to such an extent that one or more organ systems will eventu ally begin to fail with the continued health and well-being of the individual coming under threat. Age-associated deficiencies in the musculo-skeletal, cardiovascular, or endocrine systems producing arthri tis, hypertension, stroke or diabetes are all too apparent in our elderly population yet internally caused failures in the function of the nervous system provide the common, and mostly intractable, problems of memory and intellect or locomotion that face and frustrate clinicians. Perhaps the most important factor which can decide the outcome of research studies professing to examine the effects of the passage of time (i. e. the 'process of aging') on the function of the nervous system, or indeed any other organ system, is the selection of appropriate or repre sentative subjects for investigation. The heart of this problem lies in defining what might be considered as 'normal' aging as distinct from age-associated disease; setting the 'goal posts of normality' continues to 1 be a matter of considerable debate.

nly two things are certain in life, one is that all of us will inevita Obly grow older, the other is that at some point during or at the end of this process we shall die. Inherent to the passage of time is a deterio ration in the structural and functional integrity of our bodies, this pro gressing to such an extent that one or more organ systems will eventu ally begin to fail with the continued health and well-being of the individual coming under threat. Age-associated deficiencies in the musculo-skeletal, cardiovascular, or endocrine systems producing arthri tis, hypertension, stroke or diabetes are all too apparent in our elderly population yet internally caused failures in the function of the nervous system provide the common, and mostly intractable, problems of memory and intellect or locomotion that face and frustrate clinicians. Perhaps the most important factor which can decide the outcome of research studies professing to examine the effects of the passage of time (i. e. the 'process of aging') on the function of the nervous system, or indeed any other organ system, is the selection of appropriate or repre sentative subjects for investigation. The heart of this problem lies in defining what might be considered as 'normal' aging as distinct from age-associated disease; setting the 'goal posts of normality' continues to 1 be a matter of considerable debate.

It was Oscar Wilde who defined the tragedy of old age by saying that " . . . as soon as you are old enough to know better, you don't know anything at all. " As improvements in the quality of health care bring about longer life, our attention has turned from the prolonging of life to the maintenance of involvement in life. In developed nations, a full 100% increase in the ranks of the elderly has appeared and with the benefits of this prolongation have come new and greater needs of the elderly cohort. Our interest is in those processes that may lead to dementia among the elderly, for in dementia we see a thief that robs victims of their memories and their place in life. This text was conceived and developed from an international con ference on neurodevelopment, aging, and cognition; the purpose of this few days a group of experts in these conference was to bring together for a fields from around the world to generate a dialog on common themes and unresolved problems. Our hope was that by keeping the meeting small and informal, we could break through barriers of terminology unique to the areas of developmental neurobiology, neuroscience, cognitive sci ence, and clinical medicine, and have a meaningful discussion on pro cesses that affect the biological integrity and cognitive performance of the aging nervous system.

Neurogerontology tells the story of how the aging brain affects all aspects of cognition and physical performance. It comprehensively links the principles and substance of neuroscience with gerontology and psychology. Written largely from a behavioral neuroscience perspective, Neurogerontology explores the functional relationships between the central nervous system and psychological phenomena of aging, including perception, arousal, learning, cognition, and motor behavior. Willot emphasizes healthy aging, but dementia and other pathological conditions are discussed when relevant. This evidence-based approach to the neuroscience of aging makes this a valuable reference for professionals, as well as an informative textbook for students in gerontology courses.

The 1990s, appropriately termed "the decade of the brain," witnessed unprecedented advances in our knowledge of psychiatric neuroscience. Yet with every advance, we realized afresh that we were still in the beginning stages of a much longer journey. This text chronicles the next step of that journey. Structured around a proven teaching methodology that uniquely integrates the clinical aspects of psychiatric disorders with their neurobiology, this volume begins with two introductory chapters on functional neural circuitry and neural signaling pathways. The remaining six chapters present current knowledge on the neuroanatomic and neurochemical mechanisms underlying schizophrenia, addiction, anxiety, depression, bipolar disorder, and dementia/Alzheimer's disease. For clarity and consistency, each chapter features the same four divisions -- clinical presentation, neural circuitry, signaling pathways, and psychopharmacology -- as they relate to Schizophrenia, which reviews studies of the neural basis of schizophrenia and describes how the cortex, the thalamus, the basal ganglia, and the medial temporal lobe work together during normal brain function and then how each is perturbed in psychosis. Addiction, which focuses on the consequences of psychoactive substance use, including compulsive practices (e.g., eating, sex, Internet browsing) that might also involve the same brain circuits and signaling pathways. Of exceptional value are two unique illustrations that capture -- for the first time -- much of what we know about the anatomy and neurochemistry underlying the behavioral symptoms of addiction. Anxiety, which presents current hypotheses regarding neurocircuitry and signaling pathways for the three best-studied (from a neurobiologic perspective) anxiety disorders: panic disorder, posttraumatic stress disorder, and obsessive-compulsive disorder. Depression, which offers evidence for the involvement of highly interconnected cortical and limbic structures such as the prefrontal cortex, medial thalamus, amygdala, ventral striatum, hippocampus, and the hypothalamic-pituitary-adrenal axis in unipolar major depression, and suggests target areas (such as the cAMP pathway) for study in the development of new antidepressants. Bipolar disorder, which shows that specific abnormalities in signal transduction pathways, including protein kinase activity, G protein levels, and gene expression, are unique to bipolar patients, concluding that the actions of lithium and anticonvulsants on intracellular signaling pathways provide a new paradigm for novel pharmacological interventions. Dementia and Alzheimer's disease, which details current findings on neurofibrillary degeneration, relevant genes and proteins, pathogenesis (metabolic decline, defective cell repair, and Aß toxicity), and treatment strategies (neurotransmitter replacement, and neuroprotective and regenerative approaches). Discusses frontotemporal dementia, dementia with Lewy bodies, Parkinson's disease, and vascular dementia. Meticulously researched and clearly written by 15 contributors -- all recognized experts from leading research and teaching institutions in the United States -- this compact and extensively illustrated volume stands out in the literature because it combines readability and practicality with the breadth and depth typically found only in far lengthier works. Psychiatric practitioners, residents, and students alike will welcome this informative, easy-to-read text, which will also be of special interest to mental health and pharmaceutical industry professionals, and of general interest to anyone who wants to know more about the biology of psychiatric illness.

There are currently about 21 million people over 6S years in the United States and over a million of them suffer from a severe degree of mental impairment. This number will undoubtedly increase as more and more people attain their full lifespan. The Veterans Administration is acutely aware of this problem in the population it serves. Currently, there are about 31 million veterans in the United States. About 13 percent of these veterans are over 6S years of age and the number is expected to increase to 40 percent by the turn of the century. In recognition of the pressing need to address this problem, eight Geriatric Research, Educational and Clinical Centers (GRECC) have been established under the auspices of the Veterans Administration and the guiding spirit of Dr. Paul Haber, Assistant Chief Medical Director for Professional Services, Veterans Administration. The purpose of these centers is to develop a better understanding of the complex biomedical and socio-economic problems of the aged in general and to enhance the quality of life of the older veterans in particular o Gerontologists working towards a better understanding of the aging process and better care of the aged have made major progress in the biomedical field in the last decade. Among the efforts made by the Veterans Administration, the department of Extended Care and Academic Affairs have sponsored a number of symposia in the field of Gerontology.