Memory Loss, Alzheimer's Disease and Dementia: A Practical Guide for Clinicians

Title page
Table of Contents
Any screen, Any time, Anywhere
Copyright
Praise for the First Edition
Praise for the Second Edition
Preface to the Third Edition
	How To Use This Book
Acknowledgments
	Disclosures
About the Authors
Video Table of Contents
Section I: Evaluating the Patient With Memory Loss or Dementia
	1. Why Diagnose and Treat Memory Loss, Alzheimer’s Disease, and Dementia?
		Helping the Patient
		Helping the Family or Other Caregiver
		Saving Money
		Planning for the Future
		Quality Versus Quantity
		References
	2. Evaluating the Patient With Memory Loss or Dementia
		Talking With The Family
		In the Clinic
		At the Bedside
		History
		Review of Systems
		Medical History
		Allergies to Medications
		Social History
		Family History
		Physical Examination
		Cognitive Tests and Questionnaires
		Screening in the Clinic
		Laboratory Studies
		Structural Imaging Studies
		Functional Imaging Studies
		Tests that Suggest Alzheimer’s Disease
		Summary
		References
	3. Subjective Cognitive Decline, Mild Cognitive Impairment, and Dementia
		A Three-Step Approach
		The Spectrum of Cognitive Changes
		Is Dementia Present?
		Is Mild Cognitive Impairment Present?
		Is Subjective Cognitive Decline Present?
		Which Clinical Syndrome is Present?
		What is the Underlying Pathology?
		References
Section II: Differential Diagnosis of Memory Loss and Dementia
	4. Alzheimer’s Disease
		Prevalence, Prognosis, and Definition
		Alzheimer’s Pathology
		Neurochemistry
		Diagnostic Criteria
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Laboratory Studies
		Structural Imaging Studies
		Molecular and Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	5. Primary Age-Related Tauopathy
		Prevalence, Pathology, Genetics, and Definition
		Clinical Features, History, and Pattern of Impairment on Cognitive Tests
		Things to Look for on the Physical and Neurological Examination
		Laboratory Studies
		Structural Imaging Studies
		Functional and Molecular Imaging Studies
		Differential Diagnosis
		Treatments
		References
	6. Limbic-predominant Age-related TDP-43 Encephalopathy
		Prevalence, Prognosis, and Definition
		Clinical Diagnosis
		Pathology, Pathophysiology, and Genetics
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Laboratory Studies
		Structural Imaging Studies
		Functional and Molecular Imaging Studies
		Differential Diagnosis
		Treatments
		References
	7. Vascular Cognitive Impairment and Vascular Dementia
		Prevalence, Prognosis, and Definition
		Criteria
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Laboratory Studies
		Structural Imaging Studies
		Functional and Molecular Imaging Studies
		Differential Diagnosis
		Treatments (see also Table 7.1)
		References
	8. Dementia With Lewy Bodies
		Prevalence, Prognosis, and Definition
		Criteria and Diagnosis
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Laboratory, Sleep, and Electroencephalography Studies
		Structural Imaging Studies
		Functional Imaging Studies
		Differential Diagnosis
		Treatments (Table 8.2)
		References
	9. Primary Progressive Aphasia and Apraxia of Speech
		Prevalence, Definition, and Pathology
		Criteria
		Common Signs, Symptoms, and Stages (Table 9.2)
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Structural and Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	10. Behavioral Variant Frontotemporal Dementia
		Prevalence, Prognosis, and Definition
		Criteria
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages (Video 10.1)
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Laboratory Studies
		Structural and Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	11. Posterior Cortical Atrophy
		Prevalence, Definition, and Pathology
		Criteria
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Structural and Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	12. Progressive Supranuclear Palsy
		Prevalence, Prognosis, and Definition
		Terminology
		Criteria and Diagnosis
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in The History
		Things to Look for on The Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests (Videos 12.6–12.8Video 12.6Video 12.7Video 12.8)
		Laboratory Studies
		Structural Imaging Studies
		Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	13. Corticobasal Degeneration and Corticobasal Syndrome
		Prevalence, Prognosis, and Definition
		Criteria
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination (Videos 13.6 and 13.7)
		Pattern of Impairment on Cognitive Tests
		Laboratory Studies
		Structural Imaging Studies
		Functional and Molecular Imaging Studies
		Differential Diagnosis
		Treatments
		References
	14. Normal Pressure Hydrocephalus
		Prevalence, Prognosis, and Definition
		Criteria
		Risk Factors, Pathology, and Pathophysiology
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Structural Imaging Studies
		Lumbar Puncture
		Other Studies
		Differential Diagnosis and Comorbid Disorders
		Treatments
		References
	15. Chronic Traumatic Encephalopathy
		Prevalence, Definition, Pathology, and Pathophysiology
		Criteria
		Common Signs, Symptoms, and Stages
		Things to Look for in the History
		Things to Look for on the Physical and Neurological Examination
		Pattern of Impairment on Cognitive Tests
		Structural and Functional Imaging Studies
		Differential Diagnosis
		Treatments
		References
	16. Creutzfeldt–Jakob Disease
		Prevalence, Prognosis, and Definition
		Criteria
		Risk Factors, Pathology, and Pathophysiology
		Clinical Presentation
		Laboratory Studies and Electroencephalography
		Structural Imaging Studies
		Differential Diagnosis
		Treatments
		References
	17. Other Disorders That Cause Memory Loss or Dementia
		Depression and Anxiety
		Medication Side Effects
		Disrupted Sleep
		Hormones?
		Metabolic Disorders
		Diabetes
		Alcohol Abuse and Alcoholic Korsakoff’s Syndrome
		Lyme Disease
		Subdural and Epidural Hematomas
		Vitamin B12 Deficiency
		Seizures
		Human Immunodeficiency Virus–associated Neurocognitive Disorder
		Brain Sagging Syndrome
		Hashimoto’s Encephalopathy (Steroid-Responsive Encephalopathy Associated with Autoimmune Thyroiditis)
		References
Section III: Treatment of Memory Loss, Alzheimer’s Disease, and Dementia
	18. Goals for the Treatment of Memory Loss, Alzheimer’s Disease, and Dementia
		Talking About Treatments for Alzheimer’s Disease
		Strategies to Treat the Symptoms of Alzheimer’s Disease
		Treating Cognition and Treating Behavior
		References
	19. Cholinesterase Inhibitors
		Cholinesterase Inhibitors In Alzheimer’s Disease
		Should I Prescribe A Cholinesterase Inhibitor?
		Is The Medication Working?
		Which Cholinesterase Inhibitor Should I Prescribe?
		What Is The Best Dose?
		When Should the Medications be Taken?
		Does it Help to Switch Medications?
		How do i Discuss with the Patient Whether the Cholinesterase Inhibitor is Working?
		Cholinesterase Inhibitors in Late-Stage Disease
		Huperzine A
		Cholinesterase Inhibitors in Other Disorders
		References
	20. Memantine
		Mechanism of Action
		Which Patients Should Take Memantine?
		Efficacy of Memantine
		Safety and Tolerability of Memantine
		Should I Prescribe Generic Memantine or Namenda XR?
		Titrating Memantine
		Combining Memantine with Cholinesterase Inhibitors
		Memantine in the Mild Stage of Alzheimer’s Disease
		Memantine in Other Dementias
		References
	21. Vitamins, Herbs, Supplements, and Antiinflammatories
		Vitamin D
		Vitamin E
		B Complex Vitamins: Folic Acid, B6, B12
		Ginkgo Biloba
		DHA (Fish Oil)
		Antiinflammatories
		Prevagen
		References
	22. Nonpharmacological Treatment of Memory Loss, Alzheimer’s Disease, and Dementia
		Helpful Habits
		External Memory Aids
		Power of Pictures
		Magic of Music
		Mediterranean-Style Diets
		Social and Cognitively Stimulating Activities
		Aerobic Exercise
		References
	23. Future Treatments of Memory Loss, Alzheimer’s Disease, and Dementia
		Strategies to Treat the Symptoms of Alzheimer’s Disease
		Disease-Modifying Treatments
		The Future of Alzheimer’s Disease Therapy
		References
Section IV: Behavioral and Psychological Symptoms of Dementia
	24. Evaluating the Behavioral and Psychological Symptoms of Dementia
		What Constitutes Behavioral and Psychological Symptoms of Dementia?
		The Benefits of Treating Behavioral and Psychological Symptoms of Dementia
		Measuring Behavioral and Psychological Symptoms of Dementia
		Evaluating Behavioral and Psychological Symptoms of Dementia: Pragmatic Guidelines for the Clinician
		Formulating a Treatment Plan for Behavioral and Psychological Symptoms: Pragmatic Guidelines for the Clinician
		References
	25. Caring for and Educating the Caregiver
		Caring for the Caregiver
		Three Predictable Transition Points Where the Caregiver Needs Help
		References
	26. Nonpharmacological Treatment of the Behavioral and Psychological Symptoms of Dementia
		Some General Principles For Treating Behavioral And Psychological Symptoms In Dementia: The 3RS
		Dealing With Specific Behavioral And Psychological Symptoms Of Dementia: Behavioral Techniques
		References
	27. Pharmacological Treatment of the Behavioral and Psychological Symptoms of Dementia
		General Principles of Pharmacotherapy for the Behavioral and Psychological Symptoms of Dementia
		Pharmacotherapy for Depression
		Pharmacotherapy for Anxiety
		Pharmacotherapy for Pseudobulbar Affect (Pathologic Laughter and Crying)
		Pharmacotherapy for Insomnia
		Pharmacotherapy for Psychosis
		Pharmacotherapy for Agitation
		Behavioral and Psychiatric Crises
		References
Section V: Additional Issues
	28. Life Adjustments for Memory Loss, Alzheimer’s Disease, and Dementia
		Mild Cognitive Impairment and Alzheimer’s Disease Dementia In the Very Mild and Mild Stages
		Alzheimer’s Disease Dementia in the Moderate to Severe Stages
		References
	29. Legal and Financial Issues in Memory Loss, Alzheimer’s Disease, and Dementia
		Legal Planning
		Financial Planning
	30. Special Issues in Memory Loss, Alzheimer’s Disease, and Dementia
		The Patient Who Does Not Want to Come to the Appointment
		The Patient Who Does Not Want You to Talk to Their Family
		Talking to Adult Children of Patients about Their Risk of Alzheimer’s Disease And What they can do About it
		References
Appendix A. Cognitive Test and Questionnaire Forms, Instructions, and Normative Data for Evaluating Memory Loss, Alzheimer’s Disease, and Dementia
	Mental Status Tests
	Screening Instruments that Combine Single Tests
	Informant (Caregiver)-Completed Screening Questionnaires
Appendix B. Screening for Memory Loss, Alzheimer’s Disease, and Dementia
	To Screen or Not to Screen?
	Screening in Primary Care Practice
Appendix C. Memory Dysfunction in Alzheimer’s Disease and Other Causes of Mild Cognitive Impairment and Dementia
	Episodic Memory
	Semantic Memory
	Procedural Memory
	Working Memory
	Concluding Comment
Index