Evidence-based Dementia Practice

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. With the expansion of therapies, there is a clear danger of being overwhelmed by the volume of data. This book is designed to collect this information, distil what is relevant and reliable, and present it in a format that is useful to clinicians who manage and treat people with dementia. The book is designed to bring together the latest, best and practical evidence on all aspects of management, from diagnosis and therapy to social and ethical considerations. The editors are all dynamic clinicians involved in the care of patients with dementia and the evaluation of therapies. Two of the editors are the leaders of the Cochrane Collaboration for the examination of therapies for dementia. There are no other books that take such a practical and problem-oriented or approach to the diagnosis and management of dementia. Furthermore none but this can be described as truely evidence-based.

The era of therapeutic nihilism in dementia has ended, with theemergence of agents for symptomatic treatment, those that delay thecourse of the disease or prevent the onset of dementia, and newmethods to manage symptoms. With the expansion of therapies, thereis a clear danger of being overwhelmed by the volume of data.This book is designed to collect this information, distil whatis relevant and reliable, and present it in a format that is usefulto clinicians who manage and treat people with dementia. The bookis designed to bring together the latest, best and practicalevidence on all aspects of management, from diagnosis and therapyto social and ethical considerations.The editors are all dynamic clinicians involved in the care ofpatients with dementia and the evaluation of therapies. Two of theeditors are the leaders of the Cochrane Collaboration for theexamination of therapies for dementia.There are no other books that take such a practical andproblem-oriented or approach to the diagnosis and management ofdementia. Furthermore none but this can be described as truelyevidence-based.

SECTION I : Evidence-based Methods in Dementia.Introduction.Finding the evidence.Critical Appraisal.Evidence-based Etiology and Harm.Evidence-based Diagnosis.Evidence-based Prognosis.Evidence-based Interventions.Evidence-based Systematic Reviews and Meta-analyses.Evidence-based Guidelines.Evidence-based Economic Evaluation.Accessing and Using the Best Evidence Efficiently inDementia.Evidence-based Audit: Evaluating Implementation.SECTION II : Diagnosis.Introduction Practice Guidelines.Reaching a Diagnosis of Dementia.Reaching a Diagnosis of Dementia Subtype Conclusions.SECTION III : Background Facts.Historical Evolution of the Concept of Dementia: a SystematicReview From 2000 BC to 2000 AD.Alzheimer's Disease.Vascular Dementia.Lewy Body Dementia.Frontotemporal Lobar Atrophies: The Pick Complex.Other Important Dementias.Reversible or Arrestable Dementias.Mild Cognitive Impairment.SECTION IV: Overview of Treatment and Management.Aims of Treatment.Criteria for Clinical Decisions.Clinical Decisions in Practice.Delivering an Integrated Treatment Plan.What is the Evidence that a Dementia Treatment Works?.Non-pharmacological Techniques.Drugs in Development and Experimental Approaches.SECTION V: Therapies for Cognitive Symptoms, DiseaseModification and Prevention.Introduction to Specific Therapies for Cognitive Symptoms orModifying Disease Prognosis.Treatment of Alzheimer's Disease (With or WithoutCerebrovascular 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.VI.A: A Problem-oriented Approach to Common PsychiatricProblems.Introduction.Classes of Psychotropics - Overview of Evidence from ClinicalTrials.Problems.Summary, Practical Recommendations and Opinions.VI.B: A Problem-oriented Approach to Common MedicalProblems.Common Medical Problems.SECTION VII: Social, Ethical and Health ServicesIssues.Social and Ethical Issues.Driving.Care-giver Interventions.Genetic Counseling.Nursing Home Care for Patients with Dementia.Organisation of Care.Memory Clinics - a Guide to Implementation and Evaluation.Health Economics.APPENDIX 1: Diagnostic Criteria for Common Dementias.APPENDIX 2: Dementia Rating Scales.APPENDIX 3: National Alzheimer's Disease and DementiaAssociations and Societies.