The era of therapeutic nihilism in dementia has ended, with the emergence of agents for symptomatic treatment, those that delay the course of the disease or prevent the onset of dementia, and new methods to manage symptoms. This work collects information on new therapies, distills what is relevant and reliable, and presents it in a format that is useful to clinicians who manage and treat people with dementia. It brings together evidence on all aspects of the disease and its management, from diagnosis and therapy to social and ethical considerations.
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Section I Evidence-based dementia: Introduction; Finding the evidence; Appraising evidence; Evidence-based aetiology; Evidence-based diagnosis; Evidence-based prognosis; Evidence-based treatment; Evidence-based reviews and meta-analyses; Evidence-based guidelines; Evidence-based economic evaluations; Accessing and using the best evidence efficiently in dementia; Evaluating the implementation of evidence-based practice; Summary. Section II Diagnosis: Introduction; Practice guidelines; Reaching a diagnosis of dementia; Reaching a diagnosis of dementia subtype; Conclusion. Section III Background facts: Historical evolution of the concept of dementia - A systematic review from 2000 BC to 2000 AD; Alzheimers disease; Vascular dementia; Lewy Body dementia; Fronto-temporal lobar atrophies - The Pick complex; Other Important dementias; Reversible or arrestable dementias; Mild cognitive impairment and Age-Associated Memory Impairment. Section IV Overview of Treatment and Management: Aims of treatment; Criteria for clinical decisions; Clinical decisions in practice; Delivering an integrated management plan; What is the evidence that a dementia treatment works?; Non-Pharmacological techniques; Approaches of drugs in development. Section V Specific therapies for cognitive symptoms or modifying disease prognosis: Introduction; Treatment of Alzheimer's disease (with or without cerebrovascular disease); Treatment of vascular dementia; Treatment of Lewy Body dementia; Treatment of reversible or arrestable dementias; Treatment of age associated memory impairment; Prevention of dementia. Section VI Treating non-cognitive problems: a Problem-orientated approach to common psychiatric problems; A problem-orientated approach to common medical problems. Section VII Social, Ethical and Health Services Issues: Social and ethical issues; Driving Care Giver Interventions; Genetic counselling; Nursing Home Care for Patients with Dementia; Organization of care; Memory; Clinics; Health economics. Appendices: Operational diagnostic criteria; Scales commonly used in clinical practice; Resources for professional and carers.
