Dementia

Abstract Adults aged 65 and older are the fastest-growing segment of the United States population. This increase in older adults will result in a greater number of individuals with age-related neurocognitive disorders such as Alzheimer’s, vascular disease, and frontotemporal lobular degeneration. The purpose of this book is to provide trainees and early career professionals, particularly in psychiatry, psychology, neurology, geriatrics, family medicine, and internal medicine, with the information necessary to care for the often complex clinical presentations of older adults with mild cognitive impairment and dementia. The book is organized into three sections: (I) Core Concepts, (II) Dementia Syndromes, and (III) Disease Management. The chapters in Section I focus on clinical knowledge and skills that can be applied across all syndromes, including conducting the diagnostic interview and neurologic examination, frequently used cognitive screening measures, neuropsychological assessment, neuroimaging, and developing differential diagnoses. Chapters in Section II review the most common syndromes: mild cognitive impairment, Alzheimer’s disease, vascular disease, frontotemporal lobular degeneration, Lewy body and Parkinson plus syndromes, rare and rapidly progressive dementias, and dementia due to other medical conditions that may present in older adults (e.g., traumatic brain injury, hypothyroidism). Each chapter in Section II covers epidemiology, neuropathology, biomarkers, genetics (as applicable), clinical signs and symptoms (e.g., cognitive, emotional/behavioral, and motor features), and provides at least one illustrative case. Section III presents the latest evidence-based interventions, from risk management to pharmacologic and nonpharmacologic approaches. Safety considerations, legal issues, palliative and advanced care planning, and attending to caregivers are also addressed.