Dementia is most frequently associated with aging and is, at present, under-diagnosed and under-represented all over the world. Discrepancies in the diagnostic procedures and therapeutic interventions implemented in the various clinical contexts are significant and consequently, the need for a review of the currently available research evidence and a discussion of different clinical practices is urgently needed. This book provides a much needed review of the diagnostic procedures and the implementations of therapeutic interventions.

• Provides accompanying commentaries by an outstanding line up of contributors

• Covers developments in diagnosis, therapy, prognosis, economic evaluation and quality improvement

• Provides an unbiased and reliable reference point


The increase in the absolute and relative number of elderly people will be accompanied by a significant rise of the number of people with dementia. Since life expectancy at all ages is increasing faster in developing countries, the number of people with dementia will grow faster there.

The spreading of HIV infection and the prolonged survival of patients with AIDS and with other chronic diseases will further increase the number of cases of dementia. It has been estimated, for example, that—unless new and effective treatments are applied on a large scale—the number of people with dementia in Africa will, in a few years, exceed the total number of hospital beds on the continent.

Due to its progressive and disabling course, dementia also places an enormous burden on families and other carers, so that the losses in social and economic productivity due to dementia far exceed the estimates based on the epidemiological investigations of the disorder.

On the other hand, our knowledge of dementia has significantly increased. The diagnosis of the dementia syndromes has been considerably refined. New types of the disorder, such as the Lewy body dementia, have been described. Our understanding of the risk factors and the pathogenesis of Alzheimer's disease has considerably improved. Clinical and neuropsychological tools for the early diagnosis and the staging of dementia have been developed, and their usefulness in ordinary practice has been demonstrated. Promising leads for pharmacological treatment have been developed, and much has been done to facilitate the life and work of carers, by increasing training and support programmes in numbers and quality in many countries. Psychosocial interventions have also been developed and seen to be helpful in maintaining a person with dementia at a particular level of functioning without further loss and in improving the quality of life of the patients and their caregivers.

The application of new knowledge in clinical practice, however, remains inadequate almost everywhere in the world. In many countries, the vast majority of people with dementia derive no benefits from the above-mentioned advances and their living conditions are often extremely poor. Many live with their families without any kind of support from the health care system.

Psychiatrists are, on the whole, much less skilled in the early diagnosis and proper management of dementia than in the diagnosis and treatment of other disorders, such as depression or schizophrenia. The awareness of . . .

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