[...]... diagnosis and management of those psychiatric syndromes that complicate dementia illnesses Principle 1: Psychiatric Complications of Dementia Are Often the Major Contributor to Disability, Patient and Family Distress, and Costs of Care Although the core cognitive impairment associated with dementia of all types certainly represents personal and family tragedy, the complications Introduction xv of depression,... Principle 1: Biomedical Research Can Lead to a Better Understanding of the Pathophysiology of Dementing Diseases and the Development of Disease-Modifying Treatments Each of the neurology chapters summarizes scientific advances in our understanding of the pathophysiology of the most common causes of dementia and progress in the development of safe and effective disease-altering treatments An example from... patient’s behavior and to improve the psychosocial and physical environment for both the person with dementia and the caregiver(s) The psychological perspectives on dementia offered in this book highlight these three principles over and over Assessment instruments are created, extensively validated, and carefully (validly) applied to appropriate groups of persons with dementia or suspected dementia Broad-based... on chromosomes 9 and 10, and other unconfirmed loci increase the risk of sporadic late-onset AD The high prevalence of progressive dementia in subjects with Down’s syndrome (trisomy 21) led to autopsy observations of typical AD pathology, including neurofibrillary tangles and amyloid plaques, in aging brains However, the onset of dementia occurs in the third to fifth decade of life and neuropathology... prove efficacy The discovery of gene mutations in the late 1980s and 1990s linked to familial AD and a study of their effects led to the amyloid cascade hypothesis of AD This hypothesis moves Αß generation and amyloid deposition upstream from the other pathologies found in AD This hypothesis, in fact, states that Αß generation and amyloid deposition cause AD In favor of this hypothesis is the evidence... focuses on the other major causes of dementia also, with the ultimate goal of developing safe and effective disease-altering treatments for each of the major causes of dementia The successes achieved so far toward this goal are outlined in each of the neurology chapters Principle 2: A Careful History and Neurologic Examination, Supplemented by Knowledge of Dementing Diseases and Selected Ancillary Tests,... histories, and current approaches to the diagnosis of the major causes of dementia Principle 3: A Correct Diagnosis Is Essential for Providing Accurate Information about Prognosis and Initiating an Appropriate Treatment Plan The major causes of dementia in the elderly (e.g., Alzheimer’s disease, vascular dementia, dementia with Lewy bodies, frontotemporal dementia) have unique causes, clinical features, and. .. with persons with dementia and with family and professional caregivers are based on the conviction that persons with dementia, similar to those with any chronic disease, can have an improved quality of life Because dementia attacks both cognitive and noncognitive aspects of functioning, interventions are geared to both Learning theory and cognitive-behavioral theory are the underpinnings of many successful... the medical and psychosocial model Principle 1: Accurate Assessment of Both Cognitive Abilities and Noncognitive Behaviors Is Based on Thorough Knowledge of the Tools Utilized The assessment of cognition and, in particular, memory loss, has been found to be one of the most sensitive measures of early cognitive decline and dementia Psychological techniques include the valid interpretation of thorough... presentation of dementia and lobar hemorrhagic or microvascular ischemic strokes The APP E693Q mutation found in hereditary cerebral hemorrhage with amyloidosis of the Dutch type (HCHWA-D) results in an increased propensity of Αß to form amyloid and a clinical presentation of lobar hemorrhages The APP A692G mutation leads to microvascular amyloidopathy and AD pathology and presents with dementia and occasional . i HANDBOOK OF DEMENTIA ffirs.qxd 5/14/03 3:49 PM Page ii ffirs.qxd 5/14/03 3:49 PM Page iii HANDBOOK OF DEMENTIA Psychological, Neurological, and Psychiatric. Page iii HANDBOOK OF DEMENTIA Psychological, Neurological, and Psychiatric Perspectives Edited by PETER A. LICHTENBERG, DANIEL L. MURMAN, and ALAN