Review: Memory Loss, Alzheimer’s Disease and Dementia: A Practical Guide for Clinicians by Andrew E. Budson MD and Paul R. Solomon, PhD.
Those who provide commentary on modern healthcare often employ the term “silver tsunami” to describe the influx of elderly patients as the boomer generation ages. As one may expect, a large percentage of these patients seek care for cognitive complaints. With long waitlists and packed clinic days, working in a memory clinic can indeed feel like attempting to control a tsunami. Resources that assist with the provision of efficient, evidence-based care are thus invaluable. Fortunately, we have such a resource in the textbook Memory Loss, Alzheimer’s Disease and Dementia: A Practical Guide for Clinicians by cognitive neurologist Andrew E. Budson, MD and neuropsychologist Paul R. Solomon, PhD.
The book bills itself as, first and foremost, a practical guide. It contains no more or less than the information needed in a busy clinical setting. You will not find editorializing on the FDA approval of Aducanumab or detailed theorizing about links between network connectivity and memory loss - indeed, inclusion of such would detract from the book’s purpose as a practical guide. The authors effectively and efficiently provide direction on the workup and treatment of memory disorders through concise writing, aesthetically pleasing graphics, and easy-to-follow tables.
As a compact paperback book, A Practical Guide is an easily portable companion in a busy clinic. For a trainee such as myself, the book is especially valuable. For example, the book includes clear dosing ramp schedules for medications that I rarely encountered in residency, such as galantamine and memantine. Easy access to these dosing schedules definitely improves my efficiency in clinic.
The authors demonstrate an understanding of common stumbling blocks among practitioners in memory clinics and address these in a clear manner. For instance, the diagnostic distinction between dementia with Lewy bodies (DLB), Parkinson’s disease dementia, and related disorders can be a source of confusion for practitioners at all levels. A Practical Guide includes a table that clearly details the distinguishing features of these disorders.
In a similar vein, A Practical Guide includes an extremely useful table that outlines features of the primary progressive aphasia (PPA) subtypes. The table distinguishes PPA subtypes based on impairments in comprehension, naming, speech rate, and more. After doing a standard language exam, I can quickly identify which PPA subtype is most likely occurring. With this information, I can then infer the most likely underlying pathology and counsel patients on prognosis.
As someone who recently studied for the neurology boards, the “quick start” tables that initiate each chapter were especially helpful. These tables succinctly describe the definition, prevalence, signs/symptoms, diagnostic criteria, and treatment of the 14 neurodegenerative disorders presented in A Practical Guide. By presenting information clearly and concisely, the “quick start” tables facilitate rapid learning. I would thus recommend this text to neurology learners of all stages, even those who are not directly involved in clinical work.
The authors intended to write a guide valuable for providers beyond those who specialize in memory disorders - a goal they have accomplished, based on my experience. During one of her visits to Boston, my mom spotted a copy of A Practical Guide lying on my kitchen table. The book attracted her interest, since she works as a geriatrician who frequently encounters patients with memory problems. She was impressed enough by the book to purchase a copy for herself, as well as for several of her colleagues. In her words, “As the population ages, primary care providers need to know how to evaluate, diagnose, and treat memory disorders. This book helps demystify the evaluation and management of memory loss and dementia. The writing is outstanding and a pleasure to read, even replete with personal and humorous stories from the writers, accumulated from their years of experience in clinical work. The tables, graphs, and side boxes are colorful and easy to follow. The drawings and photographs are especially appreciated by the reader. I keep a copy of this book with me in my geriatric clinic, and reference it regularly. I especially find it helpful in challenging behavioral issues, such as my patient with a history of bipolar illness who now has Parkinsonism as well as delusions. We have limited access to a geropsychiatrist or cognitive neurologist, especially for institutionalized patients, and this book helps me feel confident in my treatment decisions for this patient and many others who have cognitive impairment and other associated neurologic disorders.”
In summary, A Practical Guide provides clear and concise advice for managing patients with memory disorders. In addition to providing great value in clinical practice, it is a useful resource for neurology learners at every level. Whether you are a medical student, primary care provider, or memory subspecialist, A Practical Guide will make your life easier.
About the reviewer:
Dr. HannahNoah is a cognitive neurology fellow in the Boston University/VA Boston program. She plans to pursue a career in academic neurology.
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