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Book Forum: Neuropsychiatry   |    
Memory in Neurodegenerative Disease: Biological, Cognitive, Clinical Perspectives
GARY J. TUCKER, M.D.
Am J Psychiatry 2000;157:474-a-475. doi:10.1176/appi.ajp.157.3.474-a
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edited by Alexander I. Tr�r. , New York, Cambridge University Press, 1998, 432 pp., $95.00.

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This is not a book for everyone, but almost anyone interested in behavior could find something of interest here. It is a book that should be of substantial interest to neuropsychiatrists, neuropsychologists, and geriatricians. It is a well planned and comprehensive review of memory functions in Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, Lewy body dementia, frontotemporal dementia, and several moderately rare neurodegenerative processes. The book is divided into three major sections. The first, Biological Perspectives, covers biological aspects of neurodegenerative diseases with separate chapters covering the neuropathology, imaging, and biochemical aspects of these conditions. Also included in this section are several interesting chapters on the relevance of animal studies of memory function to human memory function. The second section, Cognitive Perspectives, contains a chapter on executive functions and separate chapters delineating specific types of memory deficits (recent, remote, semantic, and procedural memory), which are usually subsumed under the general category of memory impairment. Dealing with specific aspects of memory functions in this manner lends great clarity to the types of memory impairment and allows a clear discussion of which aspect of memory is affected in each neurodegenerative disorder. The third section, Clinical Perspectives, includes not only the usual clinical and treatment data but also very interesting chapters on risk factors for each of the neurodegenerative diseases, cross-cultural issues, various aspects of psychometric performance and measurement in these conditions (e.g., the impact of depressive illness on cognitive function and testing and the impact of surgical treatment), pharmacological management, and a very thoughtful chapter on the ethical and legal issues encountered by the clinician caring for the patient with cognitive impairments. Surprisingly for a book that draws so heavily on neuropsychological data, there is little mention of the behavioral management of these conditions. Each major section has a helpful and thoughtful summary chapter.

Because there are not that many studies of memory functions in these neurodegenerative disorders, there is of necessity some overlap of information in many of the chapters. This probably cannot be avoided in a multiauthored and multidisciplinary book, but the diverse backgrounds of the contributors reveal the utility of converging lines of evidence from different disciplines in developing understanding of complex central nervous system processes.

Memory function is a complex area, often difficult to understand. Much of this difficulty is due to the many different terms used for similar memory functions or parts of memory functions. The editor of Memory in Neurodegenerative Disease has managed in most cases to keep the authors using the same terms for each aspect of memory function; in doing so he has brought a clarity to this important and difficult area. For the psychiatrist and neuropsychologist interested in this area, the chapters in the clinical section will prove invaluable. They raise but often do not answer such questions as the effect of depression on cognitive function, what cognitive skills are preserved in the various types of dementia, and when should the patient with dementia be restricted from driving.

The first section provides a good review of the biological findings in each of the conditions, and the second section is a rather exhaustive review of each measurable memory function. For those interested in a clear and comprehensive review of neurodegenerative diseases and their impact on memory and cognitive functions, this is an excellent introduction. For the researcher in these areas, this book represents a comprehensive overview that raises many important and theoretical issues. Although it is not a book that will grace every bookshelf, Memory in Neurodegenerative Disease should certainly be in most medical center and psychology department libraries.

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