INTERNATIONAL J O U R N A L OF GERIATRIC PSYCHIATRY. VOL. 10: 903-904 (1995)

BOOK REVIEWS

Dementia. By A. S . HENDERSON. Epidemiology of Mental Disorders and Psychosocial Problems. World Health Organization, Geneva 1994. No. of pages: x+62. Price: Sw. fr. 17.

This second in a welcome series of short monographs deals with the epidemiology of dementia, with special reference to problems of diagnosis and classification. Well organized and lucidly written, the text provides a useful primer and source of reference to its subject. While the diagnostic guidelines laid down by recent revisions of both ICD and DSM systems promise improved reliability in case-finding, the author notes that in a study by his own group, DSM-111-R identified many more old people as cases of dementia than did ICD- 10.

The need for research of this kind is emphasized by two tables of survey data from many countries, showing a variation in prevalence ratios from 0.5 to over 20 per

cent, and in annual incidence rates from 0.2 to 1.8 per cent, among the elderly. These disparities give little if any guidance to the distribution of risk in populations, being probably due in large part to inconsistencies in diagnostic criteria and methods, as well as in the extent of population coverage.

The more promising leads which have come from retrospective case-control studies point most strongly to genetic factors, earlier head injury, previous medical history (notable epilepsy, hypothyroidism and depres- sive illness), and exposure to aluminium or other neurotoxic substances, as possible risks for Alzheimer- type dementia. The author rightly stresses the need for prospective studies of groups with a known history of exposure to such putative causal factors.

BRIAN COOPER Institute of Psychiatry

London, U K

Facts and Research in Gerontology (Supplement): Dementia and Cognitive Impairments. By B. J. VELLAS, J. L. ALBAREDE, P. J. CARRY. (editors). Invited editor (Alzheimer’s disease) L. J. FITTEN, Serdi. Paris 1994. No. of pages: Price:

I suspect that the best way to ensure that a book is not read is to put a year on its spine (the exception proving the rule being 1984). In a rapidly evolving field like dementia a book representing the proceedings of a congress in 1993 is unlikely to get much of a readership. The title of the series begs a number of interesting questions of the relationship between facts and research but these are not explored. We are told in one piece that cognitive decline is inevitable with aging and in a later article it is not (fact or research?).

It seems (to read recent reviews) that the only way to assess a book about dementia, regardless of its other contents, is to look for references to apolipoprotein E4. Never mind what the rest is like: let us get down to this

pivotal issue. In their useful contribution on ‘Biomar- kers’ in Alzheimers disease Seubert and Schenks quote four papers from 1993. On this basis perhaps not much to write home about but this would be to miss some useful reviews on driving and dementia (Perryman and Fitten), lacunar stroke (Bruno) and verbally disruptive behaviours (Cohen-Mansfield and Warner). The original research papers presented, ranging from constipation in nursing homes to the adult education behaviours of Finnish elders, are less impressive.

Oddities of typeface and typographical errors at times disrupt the flow of reading.

The participants at this conference in Budapest may sigh wistfully at the memories invoked when they catch a glimpse of this book sitting in the shelves of their offices but they are unlikely to take it down, blow off the dust and read it again.

CHRIS BALL London Hospital Medical College, U K

Psychopharmacotherapy ,for the Elderly: Research and account of an expanding and important field. My Clinical Implications. Edited by MANFRED BERGENER, suspicion is that the contributions have been gathered R. H. BELMAKER and MEINHARDT S. TROPPER. Springer, from a meeting, perhaps the International Psycho- New York: 1993 No. of pages: 460. Price: $65.95. geriatric Association conference in Berlin, though there

is no acknowledgement of this. Most contributors are This volume contains 26 chapters which read like a from Europe, Japan and the USA. series of papers rather than a unified and comprehensive There are seven sections, the first two relating to

Q 1995 by John Wiley & Sons, Ltd