The Handbook on the Neuropsychology of Aging and Dementia is a “must have” for the bookshelves of any neuropsychologist who sees or wants to see older adults. Older adults represent the fastest growing group in our population, and it is inevitable that neuropsychologists will be increasingly asked to evaluate older individuals with a variety of cognitive problems and neuropsychiatric disorders. According to the preface of this book, 15%–20% of the baby boomer generation will develop some form of cognitive decline over the course of their lifetime, and if estimates related to the number of adults who will reach an advanced age are correct, those estimates may increase to as many as 50%.
The book is divided into two sections: the first addresses special considerations for the evaluation of older adults, and the second focuses on common disorders and referral questions specific to this population. Each chapter concludes with a list of “Clinical Pearls,” which include a list of several expert tips and key “take-home” messages on each topic summarized from the text.
With regard to the second section, focusing on specific disorders, this book fits well within the series, Clinical Handbooks in Neuropsychology, which was designed to focus on both concrete clinical descriptions and detailed instructions/recommendations regarding best assessment for the evaluation of particular patient conditions. Many disorders are reviewed, ranging from those disorders for which neuropsychologists are frequently referred individuals (e.g., mild cognitive impairment, Alzheimer's disease, Vascular Cognitive Impairment, movement disorders) to less common referrals (e.g., idiopathic normal pressure hydrocephalus, chronic obstructive pulmonary disease, hepatic encephalopathy) to variants of more common disorders with a particular focus on the elderly (e.g., epilepsy, late-onset schizophrenia, depression). The authors of these chapters are recognized experts in their fields and provide information on disease etiology, prevalence, differential diagnoses, as well as suggested test batteries and case examples to highlight the presentation of the disorder in terms of both behavioral and clinical presentation and in terms of cognitive decline. Test selection within each chapter is designed to provide thorough the assessment of the key cognitive impairments identified with each disorder, as well as to allow thoughtful consideration and evaluation of potential common differential diagnoses. Always, the focus is on particular issues associated with the assessment of older adults, taking into consideration issues such as normal age-related cognitive change and functional implications for difficulties in everyday life.
In my opinion, however, the first section of this book is what makes it stand out. In this section, special considerations in the assessment of older adults are addressed. Chapters addressing such key issues as consideration of cognitive reserve, serial assessment in dementia evaluations, the role of sleep, medication and mood disorders, management of assessment in older adults with multiple somatic symptoms, and issues related to driving evaluation, for example, provided me with significant food for thought, reassurance regarding my current practice, and useful suggestions for maximizing the time available for evaluation and gathering the most pertinent information when working with these individuals. Additional chapters focusing on important recommendations that are not always considered (e.g., environmental design for cognitive decline; prevention of cognitive decline) have provided me with additional important and meaningful information I will incorporate into my clinical evaluations. Finally, chapters addressing considerations regarding professional competence and ethical considerations when providing neuropsychological services to older adults also provided me with a roadmap by which to judge the adequacy of my own training and that of my trainees. Without a doubt, I will be incorporating many of these chapters into the didactics provided to our post-doctoral fellows in neuropsychology. I am certain the discussion prompted by this information will be lively, thoughtful, and will better prepare them as they finalize a comprehensive skill and knowledge set before moving on to start their own careers.
Hats off to Drs Lisa Ravdin and Heather Katzen for putting together such a useful, well written addition to the Clinical Handbook series, and thanks very much to this incredible group of contributors for taking the time to provide their expertise in such a thoughtful, informative, and practical manner. I recommend this book to anyone who is involved in or considering providing assessment to older adults. I guarantee it will provide you with new perspectives and/or issues to consider as you move forward in your clinical practice.