Handbook of Secondary Dementias PDF

Preface

Those disorders in which dementia tends to be the presenting and predominant neurologic feature have been referred to as the "primary dementias." The primary dementias, such as Alzheimer's disease and frontotemporal dementia, have experienced an explosive rise in prevalence as the population ages. These are neurodegenerative diseases characterized by an inexorable loss of cerebral neurons and synapses, progressive cognitive decline, and behavioral disturbances despite available therapies. Although recent scientific findings such as those related to amyloid and tau protein metabolism have greatly advanced our understanding of mechanisms of neurodegeneration, the primary dementias remain incurable.

There is another group of disorders in which dementia occurs as part of a more diverse spectrum of clinical abnormalities and is viewed as being related to another neurologic or medical condition. These are the so-called "secondary dementias." While the primary dementias have been the subject of many books and monographs, the secondary dementias have received inadequate coverage. There are a number of reasons why the secondary dementias deserve the careful attention of clinicians. Most importantly, secondary dementias are potentially reversible; therefore, they should be the focus of any clinical evaluation for a patient presenting with memory loss or other cognitive impairment. One would not want to treat a patient for the symptoms of dementia with memory-enhancing cholinesterase inhibitors or antipsychotic agents while missing an opportunity to correct an underlying cause of the dementia. Specific, effective therapies are sometimes available to treat dementia when secondary to other causes. Just like the primary forms, the secondary dementias are increasing rapidly in frequency as the population ages and as therapeutic advances allow patients to live longer with their primary disorders.

Thus, patients with a secondary dementia will commonly be encountered in clinical practice.

This is a particularly opportune time to review the secondary dementias since there has been an explosion of new knowledge in this field with specialists who specifically focus on the cognitive and behavioral aspects of a variety of medical and neurological disorders.

I am very fortunate that many of the world's best experts have agreed to convey this new knowledge to you by serving as chapter authors and I greatly appreciate their superb contributions; I think you will as well.