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Clinical Neurology of the Older Adult

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Now in its Second Edition, this text is the most up-to-date reference on the evaluation and treatment of neurologic problems in older adults.

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Editorial Reviews

From The New England Journal of Medicine

Neurologic diseases in the geriatric population have become a major health problem, both because of our success in treating nonneurologic diseases and because of the advancing wave of aging baby boomers. In addition, neurons are postmitotic, which makes the brain less able than other organs to compensate after injury. Given the increased incidence and prevalence of geriatric neurologic problems, it behooves physicians to become knowledgeable in differentiating normal aging from disease states and to develop skills in the diagnosis and management of age-associated disorders. Clinical Neurology of the Older Adult is a comprehensive book geared toward geriatricians, primary care physicians, and others who treat the elderly. The book has four sections. The first focuses on how older adults differ biologically from younger persons and describes diagnostic tests that are commonly used in elderly patients. The second section describes common symptoms that a primary care physician would encounter in practice. The third reviews diseases of the aging nervous system. The last section focuses on psychosocial issues relevant to the elderly. Clinical Neurology of the Older Adult is surprisingly clear for a book with multiple authors. Its level of detail is appropriate for primary care physicians, psychiatrists, and geriatricians and may also be useful for general neurologists who treat the elderly. It provides information both on symptoms and on diseases. The authors emphasize treatment and present more specific information about the use of various agents and dosing than most other books on the topic, in addition to information about cost differences among competing agents. All the chapters include tables and easy-to-follow algorithms for diagnosis and management. Many of the chapters also include contact information for Web sites and support groups. I particularly like the chapter entitled "Neurologic Considerations in the Postmenopausal Woman," which makes a confusing topic (the effect of sex hormones on central nervous system disease) seem straightforward. The chapter called "Cognitive Changes Associated with Normal Aging" will be informative to primary care physicians, since the elderly often wish to know whether their forgetfulness or other neurologic symptoms are abnormal. The chapters on dizziness and other common symptoms will be useful from a clinical and diagnostic perspective. The chapter on legal and ethical issues is illuminating. The book can be used as a reference, but it is also painless to read from cover to cover. There is little overlap among the chapters. All the authors are recognized in their fields, although many are not recognized in the area of geriatrics. Some chapters seem more like general neurology reviews with a few applications to geriatrics than reviews of topics in geriatrics. This book has no major weaknesses. It would have benefited from a strong overview chapter that discusses how neurologic disorders cause a major proportion of the incapacity that affects the elderly. Occasionally, an important point is downplayed in an otherwise excellent chapter. The chapter on back and neck pain (chapter 15) does not emphasize the motor and sensory features that distinguish specific spinal cord syndromes, such as Brown-Sequard's syndrome, the central cord syndrome, or the anterior cord syndrome. This chapter and some others would also have benefited from the inclusion of additional radiographs or magnetic resonance images depicting the typical radiologic appearance of urgent conditions. Since many physicians want to avoid full anticoagulation in the elderly, the chapter on ischemic stroke (chapter 17) should have included a more detailed discussion of when to use costly antiplatelet agents in place of aspirin and when there are different indications for each of the expensive agents. The chapter on the cognitive effects of stroke (chapter 18) is organized as a description of focal cognitive syndromes; it would have been more relevant if it had been organized according to vascular territory. Chapter 29 could have been broken down into several more focused chapters. In summary, Clinical Neurology of the Older Adult is a well-organized and understandable textbook on symptoms and diseases relevant to geriatric neurology. It emphasizes approaches to making the correct diagnosis and is superior to most books in its discussion of treatment and management from different perspectives. I recommend it as a practical guide for primary care physicians and others who care for elderly patients. Carol F. Lippa, M.D.
Copyright © 2003 Massachusetts Medical Society. All rights reserved. The New England Journal of Medicine is a registered trademark of the MMS. --This text refers to an alternate Hardcover edition.

Product Description

Now in its Second Edition, this text is the most up-to-date reference on the evaluation and treatment of neurologic problems in older adults. The book is organized so that clinicians can quickly look up either a patient's symptom(s) or a disease, and includes medication charts and diagnostic algorithms. Psychosocial issues such as driving and long-term care options are also addressed. This edition has more information on EMG, evoked potentials, other clinical neurophysiologic procedures, brain imaging, PET scans for dementia screening, and functional imaging in patients with cognitive changes. Updated information on new antiparkinsonian agents and paraneoplastic syndromes is also included.

Product Details

Hardcover: 653 pages
Publisher: Lippincott Williams & Wilkins; Second Edition edition (March 1, 2008)
Language: English
ISBN : 978-0781769471
Product Dimensions: 10.2 x 7.3 x 1.1 inches
Shipping Weight: 2.8 pounds